Provider Demographics
NPI:1720308091
Name:SOLIS WOMEN'S HEALTH RADIOLOGY ASSOCIATES OF NORTH CAROLINA, PC
Entity Type:Organization
Organization Name:SOLIS WOMEN'S HEALTH RADIOLOGY ASSOCIATES OF NORTH CAROLINA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-379-0941
Mailing Address - Street 1:1126 NORTH CHURCH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1035
Mailing Address - Country:US
Mailing Address - Phone:336-379-0941
Mailing Address - Fax:336-379-7997
Practice Address - Street 1:1126 N CHURCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1000
Practice Address - Country:US
Practice Address - Phone:336-379-0941
Practice Address - Fax:336-379-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085R0202X
NC2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916839Medicaid
NCD08072OtherRAILROAD MC
NC2076702Medicare PIN