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General NPI Number Information
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NPI Number | 1811424849
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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 | 05/22/2017
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Last Update Date | 05/22/2017
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Provider Practice Location Address
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Address Line | 4620 WOODY MILL RD STE G
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City | GREENSBORO
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State | NC
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Zip | 27406-8779
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Country | US
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Telephone | 336-907-3907
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Fax | 336-907-3910
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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 | 27401-1004
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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 DIRECTOR
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Name | MS. SALLY PATRICIA HAMMOND
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Credential |
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Telephone | 336-663-5007
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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 |
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License Number State |
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