Provider Demographics
NPI:1851783377
Name:PIEDMONT NEUROLOGY
Entity Type:Organization
Organization Name:PIEDMONT NEUROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:SIDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-227-5240
Mailing Address - Street 1:917 BYPASS 225 S
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-8025
Mailing Address - Country:US
Mailing Address - Phone:864-227-5240
Mailing Address - Fax:864-227-5239
Practice Address - Street 1:917 BYPASS 225 S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-8025
Practice Address - Country:US
Practice Address - Phone:864-227-5240
Practice Address - Fax:864-227-5239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty