Healthcare Provider Details

I. General information

NPI: 1225379910
Provider Name (Legal Business Name): SURRY REGIONAL HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 DUTCHMAN CT
ELKIN NC
28621-2237
US

IV. Provider business mailing address

PO BOX 1267
MOUNT AIRY NC
27030-1267
US

V. Phone/Fax

Practice location:
  • Phone: 336-835-5330
  • Fax: 336-835-5337
Mailing address:
  • Phone: 336-786-4522
  • Fax: 336-786-3752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. GREGORY SCHULZ
Title or Position: VP SURRY REGIONAL HEALTH SERVICES
Credential:
Phone: 336-783-8353