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Organization

GREENSBORO CHILDREN'S DOCTOR, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD WALTERS BOETTE M.D. (PRESIDENT)
(336) 852-9630
Entity
Organization

Contact information

Practice address
515 COLLEGE ROAD, SUITE 11, GREENSBORO, NC 27410-5150
(336) 852-9630
(336) 852-9665
Mailing address
515 COLLEGE ROAD, SUITE 11, GREENSBORO, NC 27410-5150
(336) 852-9630
(336) 852-9665

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27124
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7902775
NC
Enumeration date
10/24/2005
Last updated
08/22/2020
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