Piedmont Department of Urology, PLLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

31292 Issued in NC

Legal business name

PIEDMONT DEPARTMENT OF UROLOGY, PLLC

Practice address

350 Johnson Ridge Medical Park
Elkin, NC 28621

Phone

(336) 526-6155

Fax

(336) 526-6158

NPI assigned

Dec 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert S Grajewski, M.D.

Title

General Partner

Phone

(336) 526-6155

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922160761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 JOHNSON RIDGE MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "28621",
            "telephone_number": "336-526-6155",
            "fax_number": "336-526-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 JOHNSON RIDGE MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "28621",
            "telephone_number": "336-526-6155",
            "fax_number": "336-526-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT DEPARTMENT OF UROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAJEWSKI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "336-526-6155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": "31292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Elkin, NC
• Providers in Elkin, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.