Mantooth, Gregory Allen

Mantooth, Gregory Allen is an individual health care provider with primary practice located at 5815 Blakeney Park Dr Ste 100 , Charlotte NC 28277-5732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Mantooth, Gregory Allen can be contacted via phone (704) 542-2220.

Contact Information

Primary practice address
5815 Blakeney Park Dr Ste 100 Charlotte NC 28277-5732
Phone: (704) 542-2220
Fax: (704) 542-3304
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 200101091 North Carolina

Profile Details

NPI number 1124029707
LBN Legal business name Mantooth, Gregory Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jun 23rd, 2020 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1124029707 NPPES
North Carolina MEDICAID 8912965

Popular Providers