Provider Demographics
NPI:1699030890
Name:CAROLINA ATTENTION SPECIALISTS-GREENSBORO, PLLC
Entity Type:Organization
Organization Name:CAROLINA ATTENTION SPECIALISTS-GREENSBORO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-398-5663
Mailing Address - Street 1:3625 N ELM ST
Mailing Address - Street 2:SUITE 110 A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2604
Mailing Address - Country:US
Mailing Address - Phone:336-398-5656
Mailing Address - Fax:336-398-5665
Practice Address - Street 1:3625 N ELM ST
Practice Address - Street 2:SUITE 110 A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2604
Practice Address - Country:US
Practice Address - Phone:336-398-5656
Practice Address - Fax:336-398-5665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty