Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Greensboro Family Medicine PA

Organization Internal Medicine Physician · NPI 1104124155

Greensboro Family Medicine PA is an Internal Medicine Physician in Greensboro, North Carolina. Licensed in North Carolina. Registered with an NPI since 2011.

Licensed in
NC
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

104 W Northwood St Ste A
Greensboro, NC 27401-1326
Phone: (336) 790-0519
Fax: (336) 691-8977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 200600668 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 001000092 (NC)

Record details

NPI number1104124155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Dewar — Physician Assistant · (336) 790-0519
NPI enumeratedFebruary 28, 2011
Last updated in NPPESApril 13, 2011
Mailing address104 W Northwood St, Suite A, Greensboro, NC 27401-1326

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