Individual
GRETCHEN ELIZABETH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3186 VILLAGE DR STE 201, FAYETTEVILLE, NC 28304-3979
(910) 486-5700
(910) 486-5950
Mailing address
3186 VILLAGE DRIVE, SUITE 201, FAYETTEVILLE, NC 28304
(910) 486-5700
(910) 486-5950
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101244527
VA
2085R0202X
Diagnostic Radiology Physician
Primary
2006-00722
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053392084
—
NC
05
—
5904067
—
NC
Enumeration date
11/08/2005
Last updated
07/21/2022
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