Healthcare Provider Details

I. General information

NPI: 1821382987
Provider Name (Legal Business Name): UNIFOUR ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N CENTER ST SUITE 201
HICKORY NC
28601-5057
US

IV. Provider business mailing address

415 N CENTER ST SUITE 201
HICKORY NC
28601-5057
US

V. Phone/Fax

Practice location:
  • Phone: 828-327-8105
  • Fax: 828-327-4245
Mailing address:
  • Phone: 828-327-8105
  • Fax: 828-327-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number40254
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number40254
License Number StateNC

VIII. Authorized Official

Name: ROBERT B. STEVENS
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 828-327-8105