1548348824 NPI number — RICCOBENE-MCGEES

Table of content: HONGXIU JI M.D., PH.D. (NPI 1659328813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548348824 NPI number — RICCOBENE-MCGEES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICCOBENE-MCGEES
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:
Provider Other Organization Name Type Code:
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:
1548348824
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12330 HIGHWAY 210 SUITE 115
Provider Second Line Business Mailing Address:
SUITE 115
Provider Business Mailing Address City Name:
BENSON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-207-2077
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12330 HIGHWAY 210
Provider Second Line Business Practice Location Address:
SUITE 115
Provider Business Practice Location Address City Name:
BENSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-207-2077
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
TONIA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
919-207-2077

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  6718 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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