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MARIETTA MEDICAL CLINIC PA
NPI 1215165659
Clinic/Center in Gastonia, NC

Active since June 24, 2009
401 S MARIETTA ST, GASTONIA, NC 28052(704) 866-8030(704) 866-8717 Get Directions Write a Review

NPPES record last updated: June 24, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Marietta Medical Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIETTA MEDICAL CLINIC PA (NPI 1215165659) is a healthcare organization registered as a clinic/center in Gastonia, North Carolina and active in the NPI registry since June 2009. The organization lists Charles K Agunobi, Physician, as its authorized official.

NPPES Registry Identity

NPI1215165659
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameMARIETTA MEDICAL CLINIC PA
Location Address401 S MARIETTA STGastonia, NC 28052-4331
Mailing Address401 S Marietta StGastonia, NC 28052-4331 · (704) 866-8030 · Fax (704) 866-8717
Phone(704) 866-8030
Fax(704) 866-8717
Organization SubpartNo
Authorized OfficialCharles K AgunobiPhysician · (704) 866-8030
Enumeration DateJune 24, 2009
✔ NPI 1215165659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

401 S MARIETTA ST, Gastonia, NC 28052
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Other Identifiers 1

Medicaid5950793NC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIETTA MEDICAL CLINIC, PA
Specialist
401 S MARIETTA ST
GASTONIA, NC 28052
Gaston County (704) 866-8030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marietta Medical Clinic PA's NPI number?

The NPI number for Marietta Medical Clinic PA is 1215165659. It was assigned to this organization in the NPPES registry on June 24, 2009.

Where is Marietta Medical Clinic PA located?

Marietta Medical Clinic PA is located at 401 S Marietta St, Gastonia, NC 28052. The listed phone number is (704) 866-8030.

What is Marietta Medical Clinic PA's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Marietta Medical Clinic PA was last updated on June 24, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.