# GREENVILLE FAMILY DOCTORS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629129119
- **Authorized official:** DR. QUENTIN ALEXANDER MEWBORN JR. MD (PRESIDENT)
- **Authorized official phone:** (252) 752-7133

## Contact information

- **Practice address:** 800 MOYE BLVD STE A, GREENVILLE, NC 27834-3777
- **Practice address phone:** (252) 752-7133
- **Practice address fax:** (252) 752-6120
- **Mailing address:** 800 MOYE BLVD STE A, GREENVILLE, NC 27834-3777
- **Mailing address phone:** (252) 752-7133
- **Mailing address fax:** (252) 752-6120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2007
- **Last updated:** 05/04/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 230285 | MEDICARE PTAN | NC |
| 05 | — | 8901678 | — | NC |