Gary D Waldman MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

GARY D WALDMAN MD PA

Practice address

10512 Park Rd
Suite 113
Charlotte, NC 28210-8469

Phone

(704) 542-8018

Fax

(704) 542-7147

NPI assigned

Nov 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Wendy J Forbis

Title

Administrator

Phone

(704) 542-8018

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rachelle Maria Cronin, PAC

  • Medical Physician Assistant
  • Charlotte, NC
  • NPI 1023171121
  NPD (past)
• Laura Zuger Phillips, PA C

  • Medical Physician Assistant
  • Chapel Hill, NC
  • NPI 1497716708

  Dermatology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1851465801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 PARK RD",
            "address_2": "SUITE 113",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108469",
            "telephone_number": "704-542-8018",
            "fax_number": "704-542-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 PARK RD",
            "address_2": "SUITE 113",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108469",
            "telephone_number": "704-542-8018",
            "fax_number": "704-542-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY D WALDMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "FORBIS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-542-8018",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD7109",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0172L",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Gartland, RD
• Seth Gartner, MD
• Destiny Garvin
• Teal Venice Garvin, LCSW, LCAS, CCS
• Christopher Paul Garwacki, MD
• Joy Elaine Gary, M.D.
• Kishawna Denae Gary, MSW, LCSW-A
• Latasha G. Gary, LCMHC
• Latisha Marie Gary, BCBA
• Neva Gary, LCSW, CMSW

• Dermatology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.