MEDICARE: PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA

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	174400000X	Specialist	32718	NC

General Provider Information

NPI Number	:	1689673279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	1899 TATE BLVD SE
Second Line	:	SUITE 2101
City	:	HICKORY
State	:	NC
Zip	:	28602-4200
Country	:	US
Telephone Number	:	828-327-7788
Fax Number	:	828-327-0112

Provider Business Practice Location Address
First Line	:	1899 TATE BLVD SE
Second Line	:	SUITE 2101
City	:	HICKORY
State	:	NC
Zip	:	28602-4200
Country	:	US
Telephone Number	:	828-327-7788
Fax Number	:	828-327-0112

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	LINDA WEAVER
Credential	:
Telephone Number	:	828-327-7788

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	10/11/2021

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