MEDICARE: ROCKFORD DIGESTIVE HEALTH SPECIALISTS, P.A.

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	207RG0100X	Gastroenterology Physician	9501055	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	78894	OTHER	NC	CORPORATE CERTIFICATE

General Provider Information

NPI Number	:	1659388296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKFORD DIGESTIVE HEALTH SPECIALISTS, P.A.

Provider Business Mailing Address
First Line	:	951 ROCKFORD ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-5323
Country	:	US
Telephone Number	:	336-719-7993
Fax Number	:	336-719-6550

Provider Business Practice Location Address
First Line	:	951 ROCKFORD ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-5323
Country	:	US
Telephone Number	:	336-719-7993
Fax Number	:	336-719-6550

Authorized Official
Title or Position	:	MD
Name	:	DR. GLENN PFITZNER
Credential	:	MD
Telephone Number	:	336-719-7993

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	01/06/2012

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