Individual
ELIZABETH ANN WANEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6 N POINTE CT, GREENSBORO, NC 27408-3187
(336) 545-1020
(336) 545-6090
Mailing address
6 N POINTE CT, GREENSBORO, NC 27408-3187
(336) 545-1020
(336) 545-6090
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
38235
NC
208D00000X
General Practice Physician
38325
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020053149
RAILROAD MEDICARE
NC
01
—
400071
TRIGON BLUECROSS
NC
01
—
85561
BLUECROSS BLUESHIELD
NC
05
—
8985561
—
NC
01
—
P4948164004
CIGNA
NC
Enumeration date
04/26/2006
Last updated
08/05/2010
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