Healthcare Provider Details
I. General information
NPI: 1215986310
Provider Name (Legal Business Name): PIEDMONT CENTER FOR SPINAL DISORDERS OF VIRGINIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 W MAIN ST
DANVILLE VA
24541-2823
US
IV. Provider business mailing address
PO BOX 16534
CHAPEL HILL NC
27516-6534
US
V. Phone/Fax
- Phone: 434-792-6326
- Fax: 434-792-5122
- Phone: 919-967-6646
- Fax: 919-967-6647
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | VA |
VIII. Authorized Official
Name: DR.
LAWRENCE
F
COHEN
Title or Position: PRESIDENT
Credential: MD
Phone: 434-792-6326