Individual
BRETT GREGORY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 744-4757
(252) 744-5014
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2019-01275
NC
207P00000X
Emergency Medicine Physician
OT017327
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NN8562A
MEDICARE
NC
Enumeration date
04/04/2015
Last updated
08/02/2022
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