Individual
BRANSON PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(843) 237-3378
(843) 237-5073
Mailing address
8 OAK PARK DR, BEDFORD, MA 01730-1414
(781) 280-1699
(781) 276-6411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2008-00131
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909410
—
NC
01
—
P00616157
RAILROAD MEDICARE
NC
05
—
Q31000
—
SC
Enumeration date
05/02/2007
Last updated
04/27/2021
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