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Organization

PIEDMONT DERMATOLOGY CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NED JAY GROSS M.D. (PRESIDENT/MEDICAL DOCTOR)
(276) 666-8439
Entity
Organization

Contact information

Practice address
314 FAIRY STREET EXT, SUITE D, MARTINSVILLE, VA 24112-1913
(276) 666-8439
(276) 666-8440
Mailing address
314 FAIRY STREET EXT, SUITE D, MARTINSVILLE, VA 24112-1913
(276) 666-8439
(276) 666-8440

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101228761
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011P5
BCBS
NC
01
0308562
UNITED HEALTHCARE
NC
01
070015390
RAILROAD MEDICARE
VA
01
070015616
RAILROAD MEDICARE
NC
01
285584
ANTHEM
VA
01
7986163
AETNA
NC
01
7986163
AETNA
VA
05
89011P5
NC
01
9767433
CIGNA
NC
01
9767433
CIGNA
VA
01
A1547
MEDCOST
NC
01
A1547
MEDCOST
VA
Enumeration date
10/18/2006
Last updated
10/03/2011
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