| Guilford Medical Center, Pa | |
|
1593 Yanceyville St Suite 100, Bldg A Greensboro NC 27405-6948 | |
| (336) 275-1306 | |
| (336) 275-1307 |
| Full Name | Guilford Medical Center, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1593 Yanceyville St, Greensboro, North Carolina |
| Authorized Official Name and Position | Jyothi Nat Mann (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3362751306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guilford Medical Center, Pa 1593 Yanceyville St. Suite 100, Bldg A Greensboro NC 27405-6948 Ph: (336) 275-1306 | Guilford Medical Center, Pa 1593 Yanceyville St Suite 100, Bldg A Greensboro NC 27405-6948 Ph: (336) 275-1306 |
| NPI Number | 1003829821 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 12/05/2012 |
| Medicare PECOS PAC ID | 7113950890 |
|---|---|
| Medicare Enrollment ID | O20050913001322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003829821 | NPI | - | NPPES |
| 0254U | Other | NC | BLUE CROSS BLUE SHIELD |
| 890245U | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 2005-00334 (North Carolina) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | 930039 (North Carolina) | Primary |
| Provider Name | Jyothi N Mann |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881701928 PECOS PAC ID: 1456343615 Enrollment ID: I20040330001695 |
| Provider Name | Patrick D Hung |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164435103 PECOS PAC ID: 6002849718 Enrollment ID: I20050914000052 |
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