Individual
DR. KAORI MIYATA LONGPHRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 GREEN VALLEY ROAD, GREENSBORO, NC 27408
(336) 272-0012
Mailing address
21A OAK BRANCH DR, GREENSBORO, NC 27407-2145
(336) 478-2666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200600372
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
200600372
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5908081
—
NC
Enumeration date
08/28/2007
Last updated
12/07/2017
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