Provider Demographics
NPI:1265768485
Name:MAGEL, GEORGE DIMITRI (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DIMITRI
Last Name:MAGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7498
Mailing Address - Country:US
Mailing Address - Phone:704-671-1094
Mailing Address - Fax:704-671-1095
Practice Address - Street 1:315 19TH ST SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4230
Practice Address - Country:US
Practice Address - Phone:828-325-9849
Practice Address - Fax:828-325-9879
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201501439207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology