Individual
THOMAS W GREEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
364 WHITE OAK ST, ASHEBORO, NC 27203-5434
(336) 633-7723
Mailing address
PO BOX 4997, ASHEBORO, NC 27204-4997
(336) 629-0816
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200101209
NC
208M00000X
Hospitalist Physician
01081769A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110229431
RAILROAD MEDICARE
NC
01
—
1296T
BCBS
NC
05
—
891296T
—
NC
Enumeration date
03/16/2006
Last updated
03/22/2019
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