Organization
PIEDMONT COMMUNITY PHYSICIANS PC
Active
Parent organization
PIEDMONT COMMUNITY PHYSICIANS, PC
Other names
Vein Clinic of NC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PIEDMONT COMMUNITY PHYSICIANS, PC
Authorized official
DANA CAPPS MOODY (PRACTICE ADMINISTRATOR)
(336) 768-3530
Entity
Organization
Contact information
Practice address
3318 HEALY DR, WINSTON SALEM, NC 27103-1404
(336) 768-3530
(336) 768-1329
Mailing address
3318 HEALY DR, WINSTON SALEM, NC 27103-1404
(336) 768-3530
(336) 768-1329
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
1991-34813
NC
202K00000X
Phlebology Physician
22664
NC
208600000X
Surgery Physician
17432
NC
208VP0014X
Interventional Pain Medicine Physician
34813
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13217
BSBC NC
NC
01
—
9209243
AETNA
—
Enumeration date
05/03/2007
Last updated
08/17/2022
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