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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982817086 | NPPES |
| North Carolina | Other | 1132V | BCBS PROVIDER NUMBER |
| North Carolina | MEDICAID | 6104214 | BCBS PROVIDER NUMBER |
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