Basic Information
| Provider Information | |||||||||
| NPI: | 1588716914 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREENFIELD | ||||||||
| FirstName: | DWYNN | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 233 DOCTORS ST | ||||||||
| Address2: | 233 DOCTORS STREET | ||||||||
| City: | SPARTA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286759247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3363725511 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 233 DOCTORS ST | ||||||||
| Address2: | 233 DOCTORS STREET | ||||||||
| City: | SPARTA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286759247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3363725511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 09/27/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 201200080 | NC | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.