Organization
GREENSBORO FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JOSEPH DEWAR SR. PA-C (PHYSICIAN ASSISTANT)
(336) 790-0519
Entity
Organization
Contact information
Practice address
104 W NORTHWOOD ST, SUITE A, GREENSBORO, NC 27401-1326
(336) 790-0519
(336) 691-8977
Mailing address
104 W NORTHWOOD ST, SUITE A, GREENSBORO, NC 27401-1326
(336) 790-0519
(336) 691-8977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200600668
NC
363A00000X
Physician Assistant
001000092
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142U7
BCBSNC
NC
05
—
5907415
—
NC
01
—
87726
UNITED HEALTH CARE
NC
Enumeration date
02/28/2011
Last updated
04/13/2011
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