MARK WILLIAM MEMOLO (NPI# 1386627115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386627115 |
| Entity Type | Individual |
| Full Name | MARK WILLIAM MEMOLO |
| Credential | MD |
| Practice Address |
620 Summit Crossing Pl Ste 106 Gastonia NC 28054 |
| Practice Telephone | 7048678021 |
| Practice Fax Number | 7048644606 |
| Mailing Telephone | 7048678021 |
| Mailing Fax Number | 7048644606 |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2010-08-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
33274 | NC | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
33274 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARTNERS | 12402 | 01 | |
| BLUE CROSS BLUE SHIELD | 58609 | 01 | |
| AETNA HMO | 2353109 | 01 | |
| RAILROAD MEDICARE | 300061402 | 01 | |
| MEDCOST | 73411 | 01 | |
| UNITED HEALTHCARE | 1642996 | 01 | |
| NC | 8958609 | 05 | |
| AETNA PPO | 4630736 | 01 | |
| SC | N33274 | 05 |
| Street Address |
620 SUMMIT CROSSING PL STE 106 |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063495117 | Christopher Johannus Vandermeer | Radiology | 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054 | 2005-11-22 |
| 1962069534 | Gaston Family Health Services, Inc. | Clinic/Center | 620 Summit Crossing Pl, Gastonia, NC 28054-2176 | 2019-05-20 |
| 1356767768 | Samuel Hatchel | Physical Therapist | 620 Summit Crossing Pl, Ste 305, Gastonia, NC 28054-2176 | 2014-03-10 |
| 1003116377 | Alicia Mcquain | Physical Therapist | 620 Summit Crossing Pl, Ste 305, Gastonia, NC 28054-2176 | 2010-11-02 |
| 1942498662 | Elzbieta Bule | Physical Therapist | 620 Summit Crossing Pl, Gastonia, NC 28054-2176 | 2007-10-09 |
| 1720119696 | Margaret C Junker | Physical Therapist | 620 Summit Crossing Pl, Ste 305, Gastonia, NC 28054-2176 | 2007-03-09 |
| 1992856181 | Empicare, Inc. | Durable Medical Equipment & Medical Supplies | 620 Summit Crossing Pl, Suite 109, Gastonia, NC 28054-2176 | 2007-01-15 |
| 1821075508 | Richard Montgomery Jordan | Radiology | 620 Summit Crossing Pl, Suite 106, Gastonia, NC 28054-2176 | 2005-12-23 |
| 1306821814 | Robert William Miller | Radiology | 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054-2176 | 2005-12-08 |
| 1275517831 | Chad Michael Clark | Radiology | 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054-2176 | 2005-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629202866 | Heidi Jon Hartman | Radiology | 620 Summit Crossing Pl Ste 106, Gastonia, NC 28054-2189 | 2009-05-02 |
| 1043429152 | Sean Patrick Whalen | Radiology | 5013 Newport Landing Way, Gastonia, NC 28056-8401 | 2007-05-22 |
| 1770636268 | Mecklenburg Diagnostic Imaging LLC | Radiology | 920 Cox Rd, Bldg C Ste 101, Gastonia, NC 28054-3456 | 2007-01-19 |
| 1265480446 | Mecklenburg Diagnostic Imaging LLC | Radiology | 3723 Union Rd, Gastonia, NC 28056-8044 | 2006-05-04 |
| 1457817603 | Gaston Memorial Hospital, Incorporated | Radiology | 620 Summit Crossing Pl Ste 106, Gastonia, NC 28054-2189 | 2019-02-13 |
| 1154854503 | Mri Specialists of The Carolinas, LLC | Radiology | 620 Summit Crossing Pl Ste 106, Gastonia, NC 28054-2189 | 2017-04-04 |
| 1932435609 | Gaston Radiology | Radiology | 620 Summit Crossing Pl Ste 106, Gastonia, NC 28054-2189 | 2009-10-30 |
| 1659540219 | Charles John Girard II | Radiology | 2525 Court Dr, Gastonia, NC 28054-2140 | 2008-02-27 |
| 1326249327 | Orion Imaging, LLC | Radiology | 900 Cox Rd, Gastonia, NC 28054-3460 | 2007-05-29 |
| 1821075508 | Richard Montgomery Jordan | Radiology | 620 Summit Crossing Pl, Suite 106, Gastonia, NC 28054-2176 | 2005-12-23 |
| Find all providers in GASTONIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.