Organization
GREENSBORO EAR NOSE & THROAT ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFRY H ROSEN I MD (TREASURER)
(336) 358-4268
Entity
Organization
Contact information
Practice address
1132 N CHURCH ST, SUITE 200, GREENSBORO, NC 27401-1039
(336) 358-4268
(336) 544-7180
Mailing address
1132 N CHURCH ST, SUITE 200, GREENSBORO, NC 27401-1039
(336) 358-4268
(336) 544-7180
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
39952
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01993
BLUE CROSS BLUE SHIELD NC
NC
05
—
7001505
—
NC
05
—
8901993
—
NC
01
—
CD4175
RAILROAD MEDICARE
NC
Enumeration date
01/27/2006
Last updated
07/01/2010
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