Ganzon, Rodolfo Bautista

Ganzon, Rodolfo Bautista is an individual health care provider with primary practice located at 1500 Matthews Township Pkwy , Matthews NC 28105-4656. 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. Ganzon, Rodolfo Bautista can be contacted via phone (704) 384-9740.

Contact Information

Primary practice address
1500 Matthews Township Pkwy Matthews NC 28105-4656
Phone: (704) 384-9740
Fax: (704) 384-9565
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 200100871 North Carolina
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 200100871 North Carolina

Profile Details

NPI number 1245259365
LBN Legal business name Ganzon, Rodolfo Bautista
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Oct 25th, 2020 - about 4 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 1245259365 NPPES
North Carolina Other 12994 BC BS NC
North Carolina Other 110236348 BC BS NC
North Carolina MEDICAID N00878 BC BS NC
North Carolina MEDICAID 8912994 BC BS NC

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