Healthcare Provider Details

I. General information

NPI: 1790820215
Provider Name (Legal Business Name): PIEDMONT HEALTHCARE FOR WOMEN P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 400
GREENSBORO NC
27401-1207
US

IV. Provider business mailing address

301 E WENDOVER AVE STE 400
GREENSBORO NC
27401-1207
US

V. Phone/Fax

Practice location:
  • Phone: 336-286-6565
  • Fax: 336-286-6566
Mailing address:
  • Phone: 336-286-6565
  • Fax: 336-286-6566

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: JOHN S MCCOMB
Title or Position: MD
Credential: MD
Phone: 336-286-6565