MEDICARE: GREENSBORO SPINE AND SCOLIOSIS CENTER, PLLC

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	200200507	NC

General Provider Information

NPI Number	:	1114340213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENSBORO SPINE AND SCOLIOSIS CENTER, PLLC

Provider Business Mailing Address
First Line	:	2105 BRAXTON LN
Second Line	:	SUITE 101
City	:	GREENSBORO
State	:	NC
Zip	:	27408-2861
Country	:	US
Telephone Number	:	336-333-6306
Fax Number	:	336-333-6309

Provider Business Practice Location Address
First Line	:	4590 PREMIER DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8193
Country	:	US
Telephone Number	:	336-333-6306
Fax Number	:	336-333-6309

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MAX W COHEN
Credential	:	M.D.
Telephone Number	:	336-333-6306

Provider Enumeration Date	:	01/24/2014
Last Update Date	:	11/12/2020

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