Organization
NORTHWEST ORTHOPAEDIC ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA D SHEW RMA (REGISTERED MEDICAL ASSISTANT)
(336) 667-5039
Entity
Organization
Contact information
Practice address
1914 W PARK DR, N WILKESBORO, NC 28659-3563
(336) 667-5039
(336) 667-5719
Mailing address
1914 W PARK DR, N WILKESBORO, NC 28659-3563
(336) 667-5039
(336) 667-5719
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
40711
NC
332B00000X
Durable Medical Equipment & Medical Supplies
40711
NC
335E00000X
Prosthetic/Orthotic Supplier
40711
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1372221NORT
UMWA
NC
01
—
200004899
RR MEDICARE
NC
05
—
5950009
—
NC
Enumeration date
10/22/2007
Last updated
08/24/2011
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