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Organization
NORTH STATE MEDICAL CENTER PA
Active
Organization
NORTH STATE MEDICAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK L GODWIN MD (PRESIDENT)
(336) 599-9257
Entity
Organization
Contact information
Practice address
609 PROFESSIONAL DR, ROXBORO, NC 27573
(336) 599-9257
(336) 599-2716
Mailing address
609 PROFESSIONAL DR, ROXBORO, NC 27573
(336) 599-9257
(336) 599-2716
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02948
BCBS/NC
NC
05
—
5911497
—
NC
Enumeration date
05/03/2006
Last updated
02/06/2013
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