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General NPI Number Information
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NPI Number | 1477277549
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Entity Type | Organization
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Legal Business Name | GREENSBORO CHILDREN'S CLINIC, PA
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 2710 HENRY ST STE 100B
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City | GREENSBORO
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State | NC
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Zip | 27405-4962
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Country | US
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Telephone | 336-799-2422
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Fax | 336-617-3150
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Provider Business Mailing Address
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Address Line | 2710 HENRY ST STE 100B
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City | GREENSBORO
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State | NC
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Zip | 27405-4962
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Country | US
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Telephone | 336-799-2422
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Fax | 336-617-3150
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA REID
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Credential | MD
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Telephone | 336-799-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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