1508896895 NPI number — GREENSBORO ADULT AND ADOLESCENT INTERNAL MEDICINE PA

Table of content: CIERRA NICOLE HATFIELD-PARTIN PTA (NPI 1437791282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508896895 NPI number — GREENSBORO ADULT AND ADOLESCENT INTERNAL MEDICINE PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREENSBORO ADULT AND ADOLESCENT INTERNAL MEDICINE PA
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:
1508896895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1511 WESTOVER TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27408-7128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-378-9906
Provider Business Mailing Address Fax Number:
336-273-7495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1511 WESTOVER TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27408-7128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-378-9906
Provider Business Practice Location Address Fax Number:
336-273-7495
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WELCH
Authorized Official First Name:
EMILY
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
336-378-9906

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 890218R , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com