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General NPI Number Information
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NPI Number | 1710371976
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Entity Type | Individual
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Provider Name | MARY ELIZABETH ANNE BRANCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1301 PLEASANT VALLEY RD STE 202
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City | OWENSBORO
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State | KY
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Zip | 42303-9774
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Country | US
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Telephone | 270-417-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 888-716-9253
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 60512
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License Number State | KY
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