Healthcare Provider Details

I. General information

NPI: 1750879110
Provider Name (Legal Business Name): MACRINA BUTLER LIGUORI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MACRINA BUTLER MD

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 N CHURCH ST
GREENSBORO NC
27401-1007
US

IV. Provider business mailing address

PEDIATRIC EDUCATION OFFICE CB 7593
CHAPEL HILL NC
27599-7593
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-6500
  • Fax:
Mailing address:
  • Phone: 919-966-3172
  • Fax: 919-966-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number2021-01958
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: