Individual
THOMAS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
534 CARATOKE HWY, MOYOCK, NC 27958-8740
(252) 435-6621
(252) 435-2685
Mailing address
PO BOX 11314, BELFAST, ME 04915-4004
(757) 842-4481
(757) 312-3135
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01-01054
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1294M
BCBS OF NC
NC
05
—
891294M
—
NC
01
—
P00115557
MEDICARE RAILROAD
NC
Enumeration date
10/05/2006
Last updated
11/23/2020
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