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General NPI Number Information
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NPI Number | 1932652807
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Entity Type | Organization
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Legal Business Name | ELIZABETH DEWEY MD
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 4125 LAWNDALE DR
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City | GREENSBORO
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State | NC
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Zip | 27455-1885
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Country | US
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Telephone | 336-543-0786
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Fax | 336-234-5411
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Provider Business Mailing Address
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Address Line | 4125 LAWNDALE DR
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City | GREENSBORO
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State | NC
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Zip | 27455-1885
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Country | US
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Telephone | 336-543-0786
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Fax | 336-234-5411
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | ELIZABETH DEWEY
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Credential | MD
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Telephone | 336-543-0786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200300141
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License Number State | NC
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