Healthcare Provider Details
I. General information
NPI: 1952715500
Provider Name (Legal Business Name): BRETT AMBROSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/11/2014
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
FORT BRAGG NC
28310-7020
US
IV. Provider business mailing address
2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
FORT BRAGG NC
28310-0001
US
V. Phone/Fax
- Phone: 910-907-8922
- Fax: 910-907-6069
- Phone: 910-907-8922
- Fax: 910-907-6069
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 2021-01335 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | 2021-01335 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: