Healthcare Provider Details

I. General information

NPI: 1730636028
Provider Name (Legal Business Name): ELOHIM HOUSECALL DOCTORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 SUMMIT AVE
GREENSBORO NC
27405-4522
US

IV. Provider business mailing address

2504 SUMMIT AVE
GREENSBORO NC
27405-4522
US

V. Phone/Fax

Practice location:
  • Phone: 335-621-2500
  • Fax:
Mailing address:
  • Phone: 335-621-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number200901408
License Number StateNC

VIII. Authorized Official

Name: LEIGH SPENCER WILLIAMS
Title or Position: CFO
Credential:
Phone: 336-532-0125