MR. PIETER CAMERON VANIDERSTINE M.A. NPI 1043460165

NPI Information

NPI: 1043460165
Provider Name: MR. PIETER CAMERON VANIDERSTINE, M.A.
Classification: Psychologist - 103TM1800X
Entity Type: Individual

Specialization: Intellectual and Developmental Disabilities

Address:
122 N ELM ST
SUITE 400
GREENSBORO, NC
ZIP 27401
Phone: (336) 334-5601
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MR. Pieter Cameron Vaniderstine, M.A. is an intellectual and developmental disabilities in Greensboro, NC. MR. Pieter Cameron Vaniderstine, M.A. NPI is 1043460165. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

122 N ELM ST
SUITE 400
GREENSBORO, NC
ZIP 27401-878
Phone: (336) 334-5601
Fax: (336) 334-5657

The enumeration date for this NPI number is 9/25/2008 and was last updated on 9/25/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		1004	NORTH CAROLINA	No
2	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	1004	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3403407	MEDICAID	NORTH 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: 11/14/2023

NPI Synchronization or Removal

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