Individual
BRIAN JAMES MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1511 WESTOVER TER, SUITE 201, GREENSBORO, NC 27408-7128
(336) 373-0611
(336) 533-0866
Mailing address
1511 WESTOVER TER, SUITE 201, GREENSBORO, NC 27408-7128
(336) 373-0611
(336) 533-0866
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200401651
NC
208M00000X
Hospitalist Physician
200401651
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139EY
BLUE CROSS BLUE SHIELD
NC
01
—
193227
MEDCOST
NC
05
—
5900835
—
NC
01
—
P00223735
RAILROAD MEDICARE
NC
Enumeration date
06/15/2006
Last updated
10/26/2009
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