Healthcare Provider Details

I. General information

NPI: 1306093646
Provider Name (Legal Business Name): MAUREEN E BEN-DAVIES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 400
GREENSBORO NC
27401-1207
US

IV. Provider business mailing address

301 E WENDOVER AVE STE 400
GREENSBORO NC
27401-1207
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-3150
  • Fax: 336-832-3151
Mailing address:
  • Phone: 336-832-3150
  • Fax: 336-832-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2010-01892
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number166908
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: