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General NPI Number Information
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NPI Number | 1295134948
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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 | 08/19/2014
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 2977 CROUSE LN
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City | BURLINGTON
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State | NC
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Zip | 27215-9480
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Country | US
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Telephone | 336-584-4200
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Fax | 336-584-3616
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Provider Business Mailing Address
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Address Line | 1200 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1004
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Country | US
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Telephone | 336-832-7764
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Fax | 336-832-8272
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Authorized Official
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Title or Position | EXECUTVIE VICE PRESIDENT
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Name | ROBERT LEE GOLDSTEIN
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Credential |
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Telephone | 336-832-6250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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