Basic Information
| Provider Information | |||||||||
| NPI: | 1174981823 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REGIONAL PHYSICIANS LLC | ||||||||
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| OtherOrganizationName: | UNC REGIONAL PHYSICIANS CAROLINA CARDIOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 624 QUAKER LN | ||||||||
| Address2: | CSTE. 20 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272623832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368832500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5826 SAMET DR | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272653660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022125 | ||||||||
| FaxNumber: | 3368022675 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2016 | ||||||||
| LastUpdateDate: | 10/06/2016 | ||||||||
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| AuthorizedOfficialLastName: | CREWS | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | SHELTON | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3368832500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.