Gourdin, Frederick Walter

Gourdin, Frederick Walter is an individual health care provider with primary practice located at 78 Long Shoals Rd , Arden NC 28704-7782. He recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as his primary health care specialty. Gourdin, Frederick Walter can be contacted via phone (828) 684-0703.

Contact Information

Primary practice address
78 Long Shoals Rd Arden NC 28704-7782
Phone: (828) 684-0703
Fax: (828) 684-5344
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 9800549 North Carolina

Profile Details

NPI number 1215902663
LBN Legal business name Gourdin, Frederick Walter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215902663 NPPES
North Carolina MEDICAID 8911375

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