Healthcare Provider Details

I. General information

NPI: 1912048984
Provider Name (Legal Business Name): CHARLES W LOMAX MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W WENDOVER AVE
GREENSBORO NC
27408-8447
US

IV. Provider business mailing address

311 W WENDOVER AVE
GREENSBORO NC
27408-8447
US

V. Phone/Fax

Practice location:
  • Phone: 336-662-8185
  • Fax: 336-665-6188
Mailing address:
  • Phone: 336-662-8185
  • Fax: 336-665-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number16415
License Number StateNC

VIII. Authorized Official

Name: CHARLES W LOMAX
Title or Position: PRESIDENT
Credential: MD
Phone: 336-274-1200