Healthcare Provider Details

I. General information

NPI: 1679687586
Provider Name (Legal Business Name): GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 BETHESDA RD
WINSTON SALEM NC
27103
US

IV. Provider business mailing address

1830 S HAWTHORNE RD
WINSTON SALEM NC
27103-4047
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number StateNC

VIII. Authorized Official

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