Healthcare Provider Details
I. General information
NPI: 1538294533
Provider Name (Legal Business Name): CENTER FOR GYNECOLOGY & FERTILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2007
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1103 N. ELM ST SUITE 302
GREENSBORO NC
27401
US
IV. Provider business mailing address
1103 N. ELM ST SUITE 302
GREENSBORO NC
27401
US
V. Phone/Fax
- Phone: 336-272-0911
- Fax: 336-274-4449
- Phone: 336-272-0911
- Fax: 336-274-4449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 27256 |
| License Number State | NC |
VIII. Authorized Official
Name: DR.
HOWARD
C.
MEZER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 336-272-0911