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NPI Code Detail

MEDICARE: DR. WILLIAM KOROTITSCH

MEDICARE:  DR. WILLIAM  KOROTITSCH
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
1103T00000XPsychologist2316NC

General Provider Information

NPI Number : 1336478676
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM KOROTITSCH
Provider Business Mailing Address
First Line : 2211 W MEADOWVIEW RD
Second Line : SUITE 114
City : GREENSBORO
State : NC
Zip : 27407-3409
Country : US
Telephone Number : 336-855-4649
Fax Number : 336-855-4645
Provider Business Practice Location Address
First Line : 2211 W MEADOWVIEW RD
Second Line : SUITE 114
City : GREENSBORO
State : NC
Zip : 27407-3409
Country : US
Telephone Number : 336-855-4649
Fax Number : 336-855-4645
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2009
Last Update Date : 02/07/2015

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Directions to “ DR. WILLIAM KOROTITSCH ” Practice Location

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