Individual
DR. EDWIN JAY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1317 N ELM ST, STE 2, GREENSBORO, NC 27401-1033
(336) 373-1676
(336) 665-6188
Mailing address
1317 N ELM ST, STE 2, GREENSBORO, NC 27401-1033
(336) 373-1676
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20140
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8936887
—
NC
Enumeration date
03/24/2006
Last updated
02/01/2010
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