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Side Mack, PA
NPI 1740232966 · on the registry since 2006
Practice
- Address
- 1309 Lees Chapel Rd
Greensboro, NC 27455 - Phone
- (336) 286-5505
- Fax
- (336) 288-2900
- Organisation at this address
- Lake Jeanette Urgent Care
Diamond Family Practice, Pllc
Lake Jeanette Urgent Care, Llc
Generations Family Practice, Pa
Triad Regenerative Medicine, PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 10
Additional practice sites
- 794 S Main St Ste B, Kernersville, NC
- 1200 N Elm St, Greensboro, NC
Registry record
- Primary taxonomy
- Physician Assistant
363A00000X
- Also registered as
- Physician Assistant
- Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-02-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina