Healthcare Provider Details

I. General information

NPI: 1609787076
Provider Name (Legal Business Name): GODWIN MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E PINE ST
PINE LEVEL NC
27568
US

IV. Provider business mailing address

70 BULL DR
PRINCETON NC
27569-9200
US

V. Phone/Fax

Practice location:
  • Phone: 984-249-4180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRANDON GODWIN
Title or Position: OWNER
Credential:
Phone: 919-988-8010