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SALEM PEDIATRIC EAR AND AIRWAY CENTER PLLC NPI 1588025381


NPI Information

NPI: 1588025381
Provider Name: SALEM PEDIATRIC EAR AND AIRWAY CENTER, PLLC
Classification: Otolaryngology - 207YP0228X
Entity Type: Organization

Specialization: Pediatric Otolaryngology

Address:
615 SAINT GEORGE SQUARE CT
SUITE 364
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 245-4972
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SALEM PEDIATRIC EAR AND AIRWAY CENTER, PLLC is a pediatric otolaryngology otolaryngology in Winston Salem, NC. The provider is a pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. SALEM PEDIATRIC EAR AND AIRWAY CENTER, PLLC NPI is 1588025381. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

615 SAINT GEORGE SQUARE CT
SUITE 364
WINSTON SALEM, NC
ZIP 27103-356
Phone: (336) 245-4972
Fax: (336) 450-1676

The provider's authorized official is Adele Karen Evans .
The authorized official title is Member Manager and has the following contact phone number (919) 699-2269.

The enumeration date for this NPI number is 3/8/2016 and was last updated on 3/8/2016.


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
1207YP0228XOtolaryngologyPediatric Otolaryngology2006-00303NORTH 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
11760414866MEDICAIDNORTH 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

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