Provider Demographics
NPI:1346204088
Name:ALLIANCE UROLOGY SPECIALISTS
Entity Type:Organization
Organization Name:ALLIANCE UROLOGY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-274-1114
Mailing Address - Street 1:509 N ELAM AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1157
Mailing Address - Country:US
Mailing Address - Phone:336-274-1114
Mailing Address - Fax:336-232-5325
Practice Address - Street 1:509 N ELAM AVE
Practice Address - Street 2:FL 2
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1157
Practice Address - Country:US
Practice Address - Phone:336-274-1114
Practice Address - Fax:336-232-5325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01720OtherBCBS
NC7901720Medicaid
1297600001Medicare NSC
NC2343660Medicare PIN
2343660FMedicare PIN