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General NPI Number Information
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NPI Number | 1801085352
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Entity Type | Organization
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Legal Business Name | NORTHWEST ORTHOPAEDIC ASSOC PA
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 1914 W PARK DR
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City | N WILKESBORO
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State | NC
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Zip | 28659-3563
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Country | US
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Telephone | 336-667-5039
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Fax | 336-667-5719
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Provider Business Mailing Address
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Address Line | 1914 W PARK DR
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City | N WILKESBORO
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State | NC
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Zip | 28659-3563
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Country | US
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Telephone | 336-667-5039
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Fax | 336-667-5719
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Authorized Official
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Title or Position | REGISTERED MEDICAL ASSISTANT
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Name | SANDRA D SHEW
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Credential | RMA
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Telephone | 336-667-5039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 40711
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 40711
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 40711
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License Number State | NC
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