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General NPI Number Information
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NPI Number | 1124574827
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Entity Type | Organization
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Legal Business Name | MOSES CONE PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 4446 US HIGHWAY 220 NORTH SUITE A
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City | SUMMERFIELD
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State | NC
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Zip | 27358
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Country | US
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Telephone | 336-832-3384
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 NORTH ELM STREET
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City | GREENSBORO
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State | NC
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Zip | 27401-1020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | ROBERT L GOLDSTEIN
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Credential |
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Telephone | 336-663-5011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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