Provider Demographics
NPI:1881641819
Name:CATAWBA VALLEY EMERGENCY PHYSICIANS PA
Entity Type:Organization
Organization Name:CATAWBA VALLEY EMERGENCY PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-608-5090
Mailing Address - Street 1:PO BOX 643403
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3403
Mailing Address - Country:US
Mailing Address - Phone:800-299-4564
Mailing Address - Fax:
Practice Address - Street 1:810 FAIRGROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9617
Practice Address - Country:US
Practice Address - Phone:828-326-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89016GXMedicaid
016GXOtherBLUE CROSS/BLUE SHIELD
SCQPB989Medicaid
7388297OtherMAMSI
B0144OtherMEDCOST
7388297OtherMAMSI
SCQPB989Medicaid