Organization
PIEDMONT STONE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES H HAUSER (CEO)
(336) 714-2500
Entity
Organization
Contact information
Practice address
1907 SOUTH HAWTHORNE RD, WINSTON-SALEM, NC 27103
(336) 765-6373
(336) 765-6436
Mailing address
PO BOX 25866, WINSTON-SALEM, NC 27114-5866
(336) 714-2500
(336) 714-2556
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
261QL0400X
Lithotripsy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012AF
BCBSNC
—
Enumeration date
06/10/2006
Last updated
02/19/2019
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