Tautjo, Edward Gale Loy

Tautjo, Edward Gale Loy is an individual health care provider with primary practice located at 200 Hawthorne Ln , Charlotte NC 28204-2515. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Tautjo, Edward Gale Loy can be contacted via phone (704) 384-5416.

Contact Information

Primary practice address
200 Hawthorne Ln Charlotte NC 28204-2515
Phone: (704) 384-5416
Fax: (704) 384-5992
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 009701614 North Carolina
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 9701614 North Carolina

Profile Details

NPI number 1790786283
LBN Legal business name Tautjo, Edward Gale Loy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Feb 8th, 2023 - about 3 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 1790786283 NPPES
South Carolina MEDICAID 195808
South Carolina MEDICAID 891354Y

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