Individual
DR. BRENT BLAIR WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
646 HARTNESS RD, STATESVILLE, NC 28677-3423
(704) 872-4108
(704) 873-6517
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 838-8494
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
200301426
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000295044
UNISON HEALTH PLAN SC
SC
01
—
136WP
BCBSNC
NC
01
—
188941
MEDCOST
NC
01
—
20096157
SELECT HEALTH OF SC
SC
01
—
2407151
UNITED HEALTHCARE
NC
01
—
7833504
AETNA
—
01
—
81900
CHCARES OF SC
SC
05
—
89136WP
—
NC
05
—
G0142B
—
SC
01
—
P00292839
RAILROAD MEDICARE
—
Enumeration date
09/09/2005
Last updated
04/26/2021
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