Provider Demographics
NPI:1750659488
Name:CATAWBA VALLEY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:CATAWBA VALLEY MEDICAL GROUP, INC
Other - Org Name:CATAWBA VALLEY CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-326-3800
Mailing Address - Street 1:3521 GRAYSTONE PL SE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8201
Mailing Address - Country:US
Mailing Address - Phone:828-732-5700
Mailing Address - Fax:828-732-5701
Practice Address - Street 1:3521 GRAYSTONE PL SE
Practice Address - Street 2:SUITE 202
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8201
Practice Address - Country:US
Practice Address - Phone:828-732-5700
Practice Address - Fax:828-732-5701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATAWBA VALLEY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-08
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1750659488Medicaid
NC026CROtherNC BCBS
NC00A968Medicare Oscar/Certification