Basic Information
| Provider Information | |||||||||
| NPI: | 1154578953 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARDEE OB-GYN ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 63314 | ||||||||
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| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282633314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286960897 | ||||||||
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| Practice Location | |||||||||
| Address1: | 705 6TH AVE W | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287394164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286960897 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2008 | ||||||||
| LastUpdateDate: | 08/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | HOUSE | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8286961000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | NC | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.