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General NPI Number Information
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NPI Number | 1639382666
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Entity Type | Individual
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Provider Name | BRINDA THIMMAPPA M.D., M.B.A
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1331 N ELM ST STE 100
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City | GREENSBORO
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State | NC
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Zip | 27401-6303
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Country | US
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Telephone | 336-713-0200
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Fax | 336-713-0202
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Provider Business Mailing Address
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Address Line | 100 KIMEL FOREST DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6074
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Country | US
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Telephone | 336-716-0238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | MD60084893
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 2014-00674
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License Number State | NC
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