Healthcare Provider Details

I. General information

NPI: 1407376635
Provider Name (Legal Business Name): GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 MOORE RD
KING NC
27021
US

IV. Provider business mailing address

1830 S HAWTHORNE RD
WINSTON SALEM NC
27103-4014
US

V. Phone/Fax

Practice location:
  • Phone: 336-448-2724
  • Fax:
Mailing address:
  • Phone: 336-448-2427
  • Fax: 336-765-2869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNE HILL
Title or Position: CEO
Credential: MBA FACMPE
Phone: 336-714-3533