Organization
PIEDMONT SPINE SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GREGORY BENTLEY MD (PRESIDENT)
(919) 781-4541
Entity
Organization
Contact information
Practice address
3480 WAKE FOREST RD, SUITE 208, RALEIGH, NC 27609-7376
(919) 781-4541
(919) 781-4812
Mailing address
PO BOX 16934, CHAPEL HILL, NC 27516-6934
(919) 442-2407
(919) 967-6647
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017P7
BLUE CROSS/BLUE SHIELD
NC
05
—
5902775
—
NC
Enumeration date
06/08/2006
Last updated
12/21/2007
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