Organization
PIEDMONT COSMETIC SURGERY AND DERMATOLOGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE A SHANDRA (INSURANCE/BILLING)
(336) 760-4004
Entity
Organization
Contact information
Practice address
765 HIGHLAND OAKS DR, SUITE 100, WINSTON SALEM, NC 27103-7101
(336) 760-4004
(336) 760-6632
Mailing address
765 HIGHLAND OAKS DR, SUITE 100, WINSTON SALEM, NC 27103-7101
(336) 760-4004
(336) 760-6632
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
400362
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890238H
—
NC
Enumeration date
09/22/2006
Last updated
01/07/2010
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