Provider Demographics
NPI:1013917673
Name:ARN, ANTHONY R (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:ARN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2555 COURT DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2134
Mailing Address - Country:US
Mailing Address - Phone:704-868-3256
Mailing Address - Fax:704-868-5870
Practice Address - Street 1:2555 COURT DR
Practice Address - Street 2:SUITE 300
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2134
Practice Address - Country:US
Practice Address - Phone:704-868-3256
Practice Address - Fax:704-868-5870
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2014-08-14
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Provider Licenses
StateLicense IDTaxonomies
NC2002-01039207RC0000X
SC26703207RC0000X
NC200201039207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132GYMedicaid
SCN01031Medicaid
SCN01031Medicaid
NC89132GYMedicaid