Greensboro Children'S Doctor, Pa

LBN: Greensboro Children'S Doctor, Pa
Greensboro Children'S Doctor, Pa is an health care organization with primary practice located at 515 College Road Suite 11, Greensboro NC 27410-5150. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Greensboro Children'S Doctor, Pa can be contacted via phone (336) 852-9630, or through Boette, Richard Walters via phone (336) 852-9630.

Contact Information

Primary practice address
515 College Road Suite 11 Greensboro NC 27410-5150
Fax: (336) 852-9665
Website:
Authorized official contact:
Name: Boette, Richard Walters Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 27124 North Carolina

Profile Details

NPI number 1275523003
LBN Legal business name Greensboro Children'S Doctor, Pa
DBA Doing business as
Authorized official Boette, Richard Walters Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2005
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275523003 NPPES
North Carolina MEDICAID 7902775

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