MEDICARE: VIARENEW GREENSBORO, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	9801061	NC

General Provider Information

NPI Number	:	1013442227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIARENEW GREENSBORO, PLLC

Provider Business Mailing Address
First Line	:	5587 GARDEN VILLAGE WAY
Second Line	:	STE E
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8589
Country	:	US
Telephone Number	:	336-763-1600
Fax Number	:	336-763-6796

Provider Business Practice Location Address
First Line	:	5587 GARDEN VILLAGE WAY
Second Line	:	STE E
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8589
Country	:	US
Telephone Number	:	336-763-1600
Fax Number	:	336-763-6796

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES T SKEEN
Credential	:	M.D.
Telephone Number	:	336-763-1600

Provider Enumeration Date	:	04/25/2017
Last Update Date	:	04/25/2017

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