Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME109820 | FL |
N | 111NI0900X | Internist | ME109820 | FL |
Y | 207RG0100X | Gastroenterologist | 2015-01229 | NC |
NPI | 1033378971 |
---|---|
Provider Name | Dr. Patrick Daniel Green |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 27/06/2016 |