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General NPI Number Information
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NPI Number | 1316455223
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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 | 05/20/2024
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Provider Practice Location Address
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Address Line | 1248 HUFFMAN MILL RD STE 201
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City | BURLINGTON
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State | NC
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Zip | 27215-8700
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Country | US
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Telephone | 336-586-4001
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Fax | 336-586-4002
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Provider Business Mailing Address
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Address Line | PO BOX 745040
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City | ATLANTA
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State | GA
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Zip | 30374-5040
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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