Organization
GUILFORD MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JYOTHI NAT MANN MD (PHYSICIAN/OWNER)
(336) 275-1306
Entity
Organization
Contact information
Practice address
1593 YANCEYVILLE ST, SUITE 100, BLDG A, GREENSBORO, NC 27405-6948
(336) 275-1306
(336) 275-1307
Mailing address
1593 YANCEYVILLE ST., SUITE 100, BLDG A, GREENSBORO, NC 27405-6948
(336) 275-1306
(336) 275-1307
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
2005-00334
NC
207RG0100X
Gastroenterology Physician
Primary
930039
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0254U
BLUE CROSS BLUE SHIELD
NC
05
—
890245U
—
NC
Enumeration date
08/14/2006
Last updated
12/05/2012
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