MEDICARE: WESLEY JAMES GREENWOOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	191183	NC

General Provider Information

NPI Number	:	1669811626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY JAMES GREENWOOD M.D.

Provider Business Mailing Address
First Line	:	114 FORTE RD
Second Line	:
City	:	STEDMAN
State	:	NC
Zip	:	28391-8522
Country	:	US
Telephone Number	:	910-485-6228
Fax Number	:	910-485-3311

Provider Business Practice Location Address
First Line	:	114 FORTE RD
Second Line	:
City	:	STEDMAN
State	:	NC
Zip	:	28391-8522
Country	:	US
Telephone Number	:	910-485-6228
Fax Number	:	910-485-3311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2013
Last Update Date	:	05/13/2025

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