| Greensboro Adult And Adolescent Internal Medicine Pa | |
|
1511 Westover Ter Greensboro NC 27408-7128 | |
| (336) 378-9906 | |
| (336) 273-7495 |
| Full Name | Greensboro Adult And Adolescent Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1511 Westover Ter, Greensboro, North Carolina |
| Authorized Official Name and Position | Emily Welch (MANAGER) |
| Authorized Official Contact | 3363789906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greensboro Adult And Adolescent Internal Medicine Pa 1511 Westover Ter Greensboro NC 27408-7128 Ph: (336) 378-9906 | Greensboro Adult And Adolescent Internal Medicine Pa 1511 Westover Ter Greensboro NC 27408-7128 Ph: (336) 378-9906 |
| NPI Number | 1508896895 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 10/23/2014 |
| Medicare PECOS PAC ID | 4880735455 |
|---|---|
| Medicare Enrollment ID | O20100104000612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508896895 | NPI | - | NPPES |
| 890218R | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | William Mckeown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609806892 PECOS PAC ID: 9436290004 Enrollment ID: I20100104000609 |
| Provider Name | Dana W Mull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386747426 PECOS PAC ID: 1557674157 Enrollment ID: I20150724010586 |
| Provider Name | Ashley Creed Corbett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063990869 PECOS PAC ID: 9436492535 Enrollment ID: I20190513000844 |
| Provider Name | Tonya Renee Cranford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659983930 PECOS PAC ID: 8628498615 Enrollment ID: I20201013001177 |
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