Provider Demographics
NPI:1992350623
Name:SOUND SLEEP NEUROLOGY PLLC
Entity type:Organization
Organization Name:SOUND SLEEP NEUROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MIEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-643-2442
Mailing Address - Street 1:935 E MOUNTAIN ST STE M
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-3238
Mailing Address - Country:US
Mailing Address - Phone:336-310-4712
Mailing Address - Fax:336-450-1028
Practice Address - Street 1:345 DEVERS ST STE 102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4753
Practice Address - Country:US
Practice Address - Phone:252-643-2442
Practice Address - Fax:252-643-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty