MEDICARE: ELIZABETH MARIE KING MCINTOSH

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	235Z00000X	Speech-Language Pathologist	13028	NC

General Provider Information

NPI Number	:	1700363454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MARIE KING MCINTOSH

Provider Business Mailing Address
First Line	:	2500 N CHURCH ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-4314
Country	:	US
Telephone Number	:	336-375-2240
Fax Number	:	336-375-2214

Provider Business Practice Location Address
First Line	:	2500 N CHURCH ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-4314
Country	:	US
Telephone Number	:	336-375-2240
Fax Number	:	336-375-2214

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2018
Last Update Date	:	03/03/2026

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