Organization
PIEDMONT SURGICAL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY S MILLER (OFFICE MANAGER)
(704) 786-1104
Entity
Organization
Contact information
Practice address
431 COPPERFIELD BLVD NE, CONCORD, NC 28025-3035
(704) 786-1104
(704) 788-3112
Mailing address
431 COPPERFIELD BLVD NE, CONCORD, NC 28025-2405
(704) 786-1104
(704) 788-3112
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0127X
Trauma Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902422
—
NC
Enumeration date
01/14/2008
Last updated
11/29/2012
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