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NPI Code Detail

MEDICARE: PIEDMONT INTERNAL MEDICINE, INC

MEDICARE: PIEDMONT INTERNAL MEDICINE, INC
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
1207R00000XInternal Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C10394OTHERVAMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2006237OTHERVAANTHEM GROUP NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760439483
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIEDMONT INTERNAL MEDICINE, INC
Provider Business Mailing Address
First Line : 125 EXECUTIVE DR
Second Line : SUITE H
City : DANVILLE
State : VA
Zip : 24541-4155
Country : US
Telephone Number : 434-791-1345
Fax Number :
Provider Business Practice Location Address
First Line : 125 EXECUTIVE DR
Second Line : SUITE H
City : DANVILLE
State : VA
Zip : 24541-4155
Country : US
Telephone Number : 434-791-1345
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : VICKIE E MOSS
Credential :
Telephone Number : 434-791-1345
Provider Enumeration Date : 05/28/2006
Last Update Date : 12/04/2009

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Directions to “PIEDMONT INTERNAL MEDICINE, INC ” Practice Location

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