| Id Sol Pllc | |
|
2401 S Side Blvd Greensboro NC 27406-3311 | |
| (336) 604-2300 | |
| Not Available |
| Full Name | Id Sol Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2401 S Side Blvd, Greensboro, North Carolina |
| Authorized Official Name and Position | Anupama Matcha (PRESIDENT/OWNER) |
| Authorized Official Contact | 9542347566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Sol Pllc 6811 Koala Dr Oak Ridge NC 27310-6604 Ph: (954) 234-7566 | Id Sol Pllc 2401 S Side Blvd Greensboro NC 27406-3311 Ph: (336) 604-2300 |
| NPI Number | 1841886397 |
|---|---|
| Provider Enumeration Date | 12/18/2020 |
| Last Update Date | 12/18/2020 |
| Medicare PECOS PAC ID | 6305251364 |
|---|---|
| Medicare Enrollment ID | O20210225000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841886397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Anupama Matcha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033341565 PECOS PAC ID: 0840427514 Enrollment ID: I20131230001612 |
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