Healthcare Provider Details

I. General information

NPI: 1154588036
Provider Name (Legal Business Name): COLEY COSMETIC & HAND SURGERY CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 N ELM ST STE 120
GREENSBORO NC
27455-2696
US

IV. Provider business mailing address

3625 N ELM ST STE 120
GREENSBORO NC
27455-2696
US

V. Phone/Fax

Practice location:
  • Phone: 336-288-7676
  • Fax:
Mailing address:
  • Phone: 336-617-8645
  • Fax: 336-617-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number2008-00266
License Number StateNC

VIII. Authorized Official

Name: DR. HARRILL CHRISTOPHER COLEY
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 336-617-8645