Provider Demographics
NPI:1457542607
Name:NEUROLOGY ASSOCIATES OF NORTH CAROLINA PLLC
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF NORTH CAROLINA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-835-2038
Mailing Address - Street 1:101B ELDON PARKS DR
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2455
Mailing Address - Country:US
Mailing Address - Phone:336-835-2038
Mailing Address - Fax:336-835-4221
Practice Address - Street 1:101B ELDON PARKS DR
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2455
Practice Address - Country:US
Practice Address - Phone:336-835-2038
Practice Address - Fax:336-835-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-001462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906343Medicaid
NC2065764Medicare PIN
NC5906343Medicaid