Individual
CHARLENE EDWARDS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3625 N ELM ST, SUITE 110A, GREENSBORO, NC 27455-2604
(336) 282-4840
(336) 282-4660
Mailing address
3625 N ELM ST, SUITE 110A, GREENSBORO, NC 27455-2604
(336) 282-4840
(336) 282-4660
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9300690
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5701007
—
VA
01
—
60433
BCBS
NC
05
—
8960433
—
NC
Enumeration date
05/13/2006
Last updated
12/05/2018
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