Provider Demographics
NPI:1326346602
Name:MOSES CONE AFFILIATED PHYSICIANS, INC.
Entity Type:Organization
Organization Name:MOSES CONE AFFILIATED PHYSICIANS, INC.
Other - Org Name:PIEDMONT PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, CHMG OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-663-5007
Mailing Address - Street 1:PO BOX 745032
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-5032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:719 GREEN VALLEY RD STE 209
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7025
Practice Address - Country:US
Practice Address - Phone:336-272-9447
Practice Address - Fax:336-272-2112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MOSES H. CONE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-10
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC024YVOtherBCBSNC