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General NPI Number Information
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NPI Number | 1194233171
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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 | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 118 S SCALES ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-3834
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Country | US
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Telephone | 336-347-0511
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Fax | 336-347-0410
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Provider Business Mailing Address
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Address Line | 300 E WENDOVER AVE FL 4
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City | GREENSBORO
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State | NC
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Zip | 27401-1229
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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 DIRECTOR
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Name | SALLY PATRICIA HAMMOND
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Credential |
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Telephone | 336-663-5007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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