Provider Demographics
NPI:1821144676
Name:R GORDON SENTER MD RHEUMATOLOGY PA
Entity Type:Organization
Organization Name:R GORDON SENTER MD RHEUMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:SENTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-639-9580
Mailing Address - Street 1:405 S FULTON ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-4831
Mailing Address - Country:US
Mailing Address - Phone:704-639-9580
Mailing Address - Fax:704-633-1157
Practice Address - Street 1:405 S FULTON ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4831
Practice Address - Country:US
Practice Address - Phone:704-639-9580
Practice Address - Fax:704-633-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17738261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC89480Medicare UPIN
NC210307EMedicare ID - Type Unspecified