Healthcare Provider Details

I. General information

NPI: 1922198977
Provider Name (Legal Business Name): HIGH POINT PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 WESTWOOD AVE STE 103
HIGH POINT NC
27262
US

IV. Provider business mailing address

404 WESTWOOD AVE STE 103
HIGH POINT NC
27262
US

V. Phone/Fax

Practice location:
  • Phone: 336-889-6564
  • Fax: 336-889-5252
Mailing address:
  • Phone: 336-889-6564
  • Fax: 336-889-5252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MARYBETH CONWAY MYERS
Title or Position: DOCTOR
Credential: MD
Phone: 336-889-6564