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Organization

PIEDMONT UROLOGY ASSOCIATES PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT L WATERHOUSE JR. M.D. (PRESIDENT)
(704) 869-0075
Entity
Organization

Contact information

Practice address
924 COX RD, GASTONIA, NC 28054-3456
(704) 869-0075
(704) 869-8875
Mailing address
924 COX RD, GASTONIA, NC 28054-3456
(704) 869-0075
(704) 869-8875

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0099-01352
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02266
BCBS OF NC PROVIDER NUMBE
NC
05
8902266
NC
Enumeration date
06/01/2005
Last updated
04/30/2008
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