1992008155 NPI number — MOSES CONE AFFILIATED PHYSICIANS, INC.

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 1992008155 NPI number — MOSES CONE AFFILIATED PHYSICIANS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOSES CONE AFFILIATED PHYSICIANS, INC.
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:
6
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:
1992008155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
802 GREEN VALLEY RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27408-7041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-389-9898
Provider Business Mailing Address Fax Number:
336-275-3550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 GREEN VALLEY RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27408-7041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-389-9898
Provider Business Practice Location Address Fax Number:
336-275-3550
Provider Enumeration Date:
12/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BOGGS
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CFO/TREASURER
Authorized Official Telephone Number:
336-832-8005

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5916811 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com