| |
5921 W Friendly Ave Ste D, Greensboro, NC 27410-3268 | |
(336) 268-4100 | |
(336) 268-3158 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 5921 W Friendly Ave Ste D, Greensboro, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720794944 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 14883, Greensboro, NC 27415-4883 Ph: (336) 274-6515 | 5921 W Friendly Ave Ste D, Greensboro, NC 27410-3268 Ph: (336) 268-4100 |