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General NPI Number Information
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NPI Number | 1700317096
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Entity Type | Organization
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Legal Business Name | MOSES CONE PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 1818 RICHARDSON DRIVE SUITE E
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City | REIDSVILLE
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State | NC
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Zip | 27320-5450
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Country | US
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Telephone | 336-634-0095
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Fax | 336-616-0320
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Provider Business Mailing Address
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Address Line | 1200 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | ROBERT L GOLDSTEIN
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Credential |
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Telephone | 336-663-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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