Waldruff, Douglas L

Waldruff, Douglas L is an sole proprietor health care provider with primary practice located at 331 Martin Luther King Jr Dr , Greensboro NC 27406-1620. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Waldruff, Douglas L can be contacted via phone (336) 273-0841.

Contact Information

Primary practice address
331 Martin Luther King Jr Dr Greensboro NC 27406-1620
Phone: (336) 273-0841
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2236 North Carolina
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 426 North Carolina

Profile Details

NPI number 1982817086
LBN Legal business name Waldruff, Douglas L
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 7th, 2007
Last updated Feb 15th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982817086 NPPES
North Carolina Other 1132V BCBS PROVIDER NUMBER
North Carolina MEDICAID 6104214 BCBS PROVIDER NUMBER

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