Individual
HEIDI LOUISE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4020 CAPITAL BLVD STE 102, CAROLINA COMMUNITY MENTAL HEALTH CENTERS, RALEIGH, NC 27604-3474
(919) 875-3211
(919) 875-4122
Mailing address
4020 CAPITAL BLVD STE 102, CAROLINA COMMUNITY MENTAL HEALTH CENTERS, RALEIGH, NC 27604-3474
(919) 875-3211
(919) 875-4122
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200300796
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134VC
BCBS
NC
01
—
2018243A
MEDICARE
NC
01
—
477015
HUMANA GOLD CHOICE
—
05
—
89134VC
—
NC
Enumeration date
07/19/2006
Last updated
04/01/2010
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