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General NPI Number Information
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NPI Number | 1568597417
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Entity Type | Individual
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Provider Name | KATHRYN ANNE SHICK MD
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 1941 NEW GARDEN RD
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City | GREENSBORO
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State | NC
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Zip | 27410-2554
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Country | US
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Telephone | 336-288-8857
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Fax | 336-288-8769
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Provider Business Mailing Address
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Address Line | PO BOX 751803
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City | CHARLOTTE
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State | NC
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Zip | 28275-1803
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Country | US
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Telephone | 336-288-8857
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Fax | 336-288-8769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9800389
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License Number State | NC
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