Basic Information
| Provider Information | |||||||||
| NPI: | 1982066643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUNN | ||||||||
| FirstName: | EDWIN | ||||||||
| MiddleName: | CORY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1350 S KINGS DR | ||||||||
| Address2: | 3RD FLOOR MYERS PARK CLINIC INTERNAL MEDICINE | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282072134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044461242 | ||||||||
| FaxNumber: | 7044461241 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 S KINGS DR | ||||||||
| Address2: | 3RD FLOOR MYERS PARK CLINIC INTERNAL MEDICINE | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282072134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044461242 | ||||||||
| FaxNumber: | 7044461241 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 03/24/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 217745 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.