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General NPI Number Information
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NPI Number | 1043172471
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Entity Type | Organization
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Legal Business Name | SANDHILLS PEDIATRICS
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 2808 MAPLEWOOD AVE
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City | WINSTON SALEM
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State | NC
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Zip | 27103-4138
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Country | US
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Telephone | 336-765-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 105 PAVILION WAY
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4556
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Country | US
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Telephone | 910-692-2444
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Fax | 910-692-3651
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Authorized Official
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Title or Position | PARTNER
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Name | CHRISTOPH ROBERT DIASIO
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Credential |
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Telephone | 910-692-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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