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General NPI Number Information
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NPI Number | 1972949949
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Entity Type | Organization
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Legal Business Name | MOSES CONE AFFILIATED PHYSICIANS, INC.
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 1611 FLORA AVE
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City | BURLINGTON
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State | NC
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Zip | 27217-1017
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Country | US
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Telephone | 336-270-5622
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 FLORA AVE
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City | BURLINGTON
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State | NC
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Zip | 27217-1017
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Country | US
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Telephone | 336-270-5622
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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 LEE GOLDSTEIN
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Credential |
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Telephone | 336-832-6250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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