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Organization
PIEDMONT GYNECOLOGICAL AND OBSTETRICAL ASSOCIATES
Active
Organization
PIEDMONT GYNECOLOGICAL AND OBSTETRICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL L WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
704 GOLD HILL ROAD, STE 215, FORT MILL, SC 29715-8907
(803) 835-0434
(704) 512-2731
Mailing address
PO BOX 601067, CHARLOTTE, NC 28260-1067
(803) 835-0434
(704) 512-2731
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89013AH
—
NC
05
—
89013AJ
—
NC
05
—
PA6136
—
SC
Enumeration date
07/08/2006
Last updated
11/28/2012
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