Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gina Licause, MD

Individual provider Family Medicine Physician · NPI 1699762039

Gina Licause, MD is a Family Medicine Physician in Charlotte, North Carolina. Works from 5 locations. Licensed in North Carolina.

Licensed in
NC
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 E Wt Harris Blvd Ste 5002
Charlotte, NC 28262-3485
Phone: (704) 801-7310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 10226 Couloak Dr, Charlotte, NC 28216-7675 — (704) 801-7380
  • 101 E W T Harris Blvd, Charlotte, NC 28262-3485 — (704) 863-9700
  • 14214 Ballantyne Lake Rd, Charlotte, NC 28277-3372 — (704) 667-2650
  • 150 Professional Park Dr, Mooresville, NC 28117-5603 — (704) 801-7360

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 35695 (NC)

Record details

NPI number1699762039
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 30, 2005
Last updated in NPPESSeptember 27, 2021
Certification dateMay 3, 2020

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