Organization
INTERNAL MEDICINE GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE B. RABY (OFFICE MANAGER)
(828) 728-0112
Entity
Organization
Contact information
Practice address
415 N CENTER ST, SUITE 001, HICKORY, NC 28601-5036
(828) 322-9199
(828) 322-6424
Mailing address
415 N CENTER ST, SUITE 001, HICKORY, NC 28601-5036
(828) 322-9199
(828) 322-6424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
56942
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02380
BCBS OF NC
NC
05
—
7902380
—
NC
Enumeration date
03/27/2006
Last updated
08/22/2020
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