Provider Demographics
NPI:1841558715
Name:ATLAS HOSPITALIST SERVICES PC
Entity Type:Organization
Organization Name:ATLAS HOSPITALIST SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MCKAY
Authorized Official - Middle Name:BENSEN
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-682-8990
Mailing Address - Street 1:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-0479
Mailing Address - Country:US
Mailing Address - Phone:336-682-8990
Mailing Address - Fax:205-874-8333
Practice Address - Street 1:2401 S SIDE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3311
Practice Address - Country:US
Practice Address - Phone:336-682-8990
Practice Address - Fax:205-874-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5920815Medicaid
NCB203Medicare PIN