Individual
KATHRYN MCCONNELL GREVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-3600
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
29115
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186147000
—
WV
01
—
37203
BCBS
—
01
—
4036
PARTNERS
—
01
—
42342
MEDCOST
—
01
—
5508264
AETNA
—
05
—
7252269
—
VA
05
—
8937203
—
NC
Enumeration date
11/18/2005
Last updated
08/04/2015
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