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General NPI Number Information
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NPI Number | 1376635086
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Entity Type | Organization
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Legal Business Name | GUILFORD INTERNAL MEDICINE ASSOCIATES, PA
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2710 HENRY ST SUITE 100-B
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City | GREENSBORO
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State | NC
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Zip | 27405-4961
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Country | US
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Telephone | 336-954-1007
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Fax | 336-954-1183
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Provider Business Mailing Address
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Address Line | PO BOX 13118
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City | GREENSBORO
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State | NC
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Zip | 27415-3118
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Country | US
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Telephone | 336-954-1007
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Fax | 336-954-1183
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC L DEAN
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Credential | M.D.
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Telephone | 336-954-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 53129
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License Number State | NC
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