Provider Demographics
NPI:1689125858
Name:RDMG ASSOCIATES PA
Entity Type:Organization
Organization Name:RDMG ASSOCIATES PA
Other - Org Name:SEASIDE WELLNESS OF SHALLOTTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-614-0301
Mailing Address - Street 1:PO BOX 63103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3103
Mailing Address - Country:US
Mailing Address - Phone:919-233-5952
Mailing Address - Fax:312-324-7850
Practice Address - Street 1:4503 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4583
Practice Address - Country:US
Practice Address - Phone:910-754-2273
Practice Address - Fax:910-754-2254
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RDMG ASSOCIATES PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty