Healthcare Provider Details

I. General information

NPI: 1619141603
Provider Name (Legal Business Name): JEFFREY MORGAN DENNEY M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BLVD DEPT. OB/GYN, MFM SECTION (C/O PORTIA ELLERBE)
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

MEDICAL CENTER BLVD DEPT. OB/GYN, MFM SECTION (C/O PORTIA ELLERBE)
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4594
  • Fax:
Mailing address:
  • Phone: 336-716-4594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number2013-00486
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: