MEDICARE: PIEDMONT INFECTIOUS DISEASE CONSULTANTS P A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	9900415	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053403873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIEDMONT INFECTIOUS DISEASE CONSULTANTS P A

Provider Business Mailing Address
First Line	:	1985 TATE BLVD., SE
Second Line	:	FIRST PLAZA BLDG., STE 720
City	:	HICKORY
State	:	NC
Zip	:	28602-1433
Country	:	US
Telephone Number	:	828-304-4935
Fax Number	:

Provider Business Practice Location Address
First Line	:	1985 TATE BLVD., SE
Second Line	:	FIRST PLAZA BLDG., STE 720
City	:	HICKORY
State	:	NC
Zip	:	28602-1433
Country	:	US
Telephone Number	:	828-304-4935
Fax Number	:	828-304-4936

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. GRACE M AUTEN
Credential	:	M.D.
Telephone Number	:	828-304-4935

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	10/19/2010

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