Healthcare Provider Details

I. General information

NPI: 1508059213
Provider Name (Legal Business Name): PIEDMONT HEALTHCARE FOR WOMEN, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2007
Last Update Date: 08/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 GREEN VALLEY RD SUITE 201
GREENSBORO NC
27408-7014
US

IV. Provider business mailing address

719 GREEN VALLEY RD SUITE 201
GREENSBORO NC
27408-7014
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-1110
  • Fax: 336-378-9986
Mailing address:
  • Phone: 336-378-1110
  • Fax: 336-378-9986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK EDWARD ANDERSON
Title or Position: TREASURER
Credential: M.D.
Phone: 336-378-1110