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General NPI Number Information
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NPI Number | 1417180662
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE &PSYCHIATRIC SERVICES OF THE PIEDMONT
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 929 15TH ST NE SUITE 100
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City | HICKORY
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State | NC
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Zip | 28601-4161
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Country | US
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Telephone | 828-325-0555
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Fax | 828-267-7555
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Provider Business Mailing Address
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Address Line | PO BOX 1447
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City | HICKORY
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State | NC
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Zip | 28603-1447
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Country | US
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Telephone | 828-325-0555
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Fax | 828-267-7555
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. TERESA P KILLIAN
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Credential |
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Telephone | 828-325-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 200501179
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 200501179
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License Number State | NC
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