Provider Demographics
NPI:1033130117
Name:UWHARRIE REGIONAL PEDIATRICS, PA
Entity Type:Organization
Organization Name:UWHARRIE REGIONAL PEDIATRICS, PA
Other - Org Name:ALBEMARLE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:WILLIAMSON
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-982-5437
Mailing Address - Street 1:1420 US HIGHWAY 52 NORTH
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-2622
Mailing Address - Country:US
Mailing Address - Phone:704-982-5437
Mailing Address - Fax:704-982-4843
Practice Address - Street 1:1420 US HIGHWAY 52 NORTH
Practice Address - Street 2:SUITE A
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2622
Practice Address - Country:US
Practice Address - Phone:704-982-5437
Practice Address - Fax:704-982-4843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890260JMedicaid