Healthcare Provider Details

I. General information

NPI: 1346250214
Provider Name (Legal Business Name): PIEDMONT RHEUMATOLOGY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 18TH ST SE
HICKORY NC
28602-1364
US

IV. Provider business mailing address

225 18TH ST SE
HICKORY NC
28602-1364
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-1996
  • Fax: 828-322-4078
Mailing address:
  • Phone: 828-322-1996
  • Fax: 828-322-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: KENDRA LEATHERMAN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 828-322-9912