1174981823 NPI number — REGIONAL PHYSICIANS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174981823 NPI number — REGIONAL PHYSICIANS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL PHYSICIANS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UNC REGIONAL PHYSICIANS CAROLINA CARDIOLOGY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174981823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
624 QUAKER LN
Provider Second Line Business Mailing Address:
CSTE. 20
Provider Business Mailing Address City Name:
HIGH POINT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27262-3832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-883-2500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5826 SAMET DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27265-3660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-802-2125
Provider Business Practice Location Address Fax Number:
336-802-2675
Provider Enumeration Date:
02/09/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CREWS
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
SHELTON
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
336-883-2500

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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