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36 14th Ave Ne Ste 2b Hickory NC 28601-2580 | |
(828) 757-6275 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 36 14th Ave Ne Ste 2b, Hickory, North Carolina |
Authorized Official Name and Position | Karen Shadowens (CFO) |
Authorized Official Contact | 3366278512 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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321 Mulberry St Sw Lenoir NC 28645-5720 Ph: (182) 875-7510 | 36 14th Ave Ne Ste 2b Hickory NC 28601-2580 Ph: (828) 757-6275 |
NPI Number | 1831965201 |
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Provider Enumeration Date | 11/28/2023 |
Last Update Date | 01/21/2025 |
Medicare PECOS PAC ID | 5395646970 |
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Medicare Enrollment ID | O20240402000752 |
Identifier | Type | State | Issuer |
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1831965201 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Steven Tomski |
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Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1083666135 PECOS PAC ID: 8820048630 Enrollment ID: I20061013000470 |
Provider Name | Richelle C Miller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730330267 PECOS PAC ID: 0345392478 Enrollment ID: I20090720000608 |
Provider Name | Duane M Moise |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1780656439 PECOS PAC ID: 0547272007 Enrollment ID: I20100802000256 |
Provider Name | Jamie Millicent Boone |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265949747 PECOS PAC ID: 8628331345 Enrollment ID: I20180411001450 |
Provider Name | Michael Joseph Kilby |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922728773 PECOS PAC ID: 6709115603 Enrollment ID: I20221123002700 |
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