Provider Demographics
NPI:1952678013
Name:CATAWBA VALLEY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:CATAWBA VALLEY MEDICAL GROUP, INC
Other - Org Name:CATAWBA VALLEY FAMILY MEDICINE - NORTH HICKORY
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 1:212 29TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1084
Mailing Address - Country:US
Mailing Address - Phone:828-732-5350
Mailing Address - Fax:828-732-5351
Practice Address - Street 1:212 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1084
Practice Address - Country:US
Practice Address - Phone:828-732-5350
Practice Address - Fax:828-732-5351
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATAWBA VALLEY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952678013Medicaid
NC026CYOtherNC BCBS
NC026CYOtherNC BCBS