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General NPI Number Information
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NPI Number | 1679143655
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Entity Type | Organization
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Legal Business Name | MOBILE URGENT SPECIALIZED TREATMENT CLINIC
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 5309 HIGHSTREAM CT
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City | GREENSBORO
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State | NC
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Zip | 27407
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Country | US
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Telephone | 336-988-6878
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 W GATE CITY BLVD STE K
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City | GREENSBORO
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State | NC
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Zip | 27407-7047
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Country | US
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Telephone | 336-988-6878
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ZOE ALECIA STALLINGS
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Credential | M.D.
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Telephone | 336-988-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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