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PIEDMONT COSMETIC SURGERY AND DERMATOLOGY CENTER PA NPI 1356440663


NPI Information

NPI: 1356440663
Provider Name: PIEDMONT COSMETIC SURGERY AND DERMATOLOGY CENTER, PA
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 34D0916100

Address:
765 HIGHLAND OAKS DR
SUITE 100
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 760-4004
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PIEDMONT COSMETIC SURGERY AND DERMATOLOGY CENTER, PA is a specialist in Winston Salem, NC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PIEDMONT COSMETIC SURGERY AND DERMATOLOGY CENTER, PA NPI is 1356440663. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

765 HIGHLAND OAKS DR
SUITE 100
WINSTON SALEM, NC
ZIP 27103-101
Phone: (336) 760-4004
Fax: (336) 760-6632

The provider's authorized official is Renee A Shandra .
The authorized official title is Insurance/billing and has the following contact phone number (336) 760-4004.

The CLIA number assigned to this NPI record is 34D0916100 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 1/7/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist400362NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1890238HMEDICAIDNORTH CAROLINA
21616MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.