MEDICARE: VALERIE JEANETTE FIELDS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME74518	FL

General Provider Information

NPI Number	:	1043399835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE JEANETTE FIELDS MD

Provider Business Mailing Address
First Line	:	4380 FEDERAL DR
Second Line	:	SUITE1
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8148
Country	:	US
Telephone Number	:	336-315-6270
Fax Number	:	336-235-0435

Provider Business Practice Location Address
First Line	:	4380 FEDERAL DR
Second Line	:	SUITE1
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8148
Country	:	US
Telephone Number	:	336-315-6270
Fax Number	:	336-235-0435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	01/07/2008

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