Organization
MOSES CONE PHYSICIAN SERVICES, INC.
Active
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITAL
Other names
Cone Health Child Neurology
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MOSES H. CONE MEMORIAL HOSPITAL
Authorized official
KENNETH K BOGGS (CFO AND TREASURER)
(336) 832-8005
Entity
Organization
Contact information
Practice address
1103 N ELM ST, SUITE 300, GREENSBORO, NC 27401-6309
(336) 271-3331
(336) 271-3724
Mailing address
1200 N ELM ST, CONE HEALTH, ADMINISTRATIVE SERVICES, SUITE 201, GREENSBORO, NC 27401-1004
(336) 832-7764
(336) 832-8272
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025TH
BCBS NC
NC
05
—
5918953
—
NC
Enumeration date
12/01/2011
Last updated
08/13/2012
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