| Gretchen Elizabeth Green, MD | |
|
3186 Village Dr Ste 201, Fayetteville, NC 28304-3979 | |
| (910) 486-5700 | |
| (910) 486-5950 |
| Full Name | Gretchen Elizabeth Green |
|---|---|
| Gender | Female |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 3186 Village Dr Ste 201, Fayetteville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053392084 | NPI | - | NPPES |
| 5904067 | Medicaid | NC | |
| 1053392084 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 0101244527 (Virginia) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 2006-00722 (North Carolina) | Primary |
| Entity Name | Valley Radiology P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093723538 PECOS PAC ID: 0749181089 Enrollment ID: O20040119000580 |
| Entity Name | Bladen Healthcare Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558537282 PECOS PAC ID: 6800967969 Enrollment ID: O20080617000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Gretchen Elizabeth Green, MD 3186 Village Drive, Suite 201, Fayetteville, NC 28304 Ph: (910) 486-5700 | Gretchen Elizabeth Green, MD 3186 Village Dr Ste 201, Fayetteville, NC 28304-3979 Ph: (910) 486-5700 |
Dr. Andrew Bostaph, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3027 Hampton Ridge Rd, Fayetteville, NC 28311 Phone: 303-933-8270 Fax: 972-437-3369 | |
Sheryl Gillikin Jordan, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 1301 Medical Dr, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
James E. Shearer, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3186 Village Dr 201, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
Irene Vasko, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3186 Village Dr Ste 201, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
Leroy Roberts Jr., M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3186 Village Dr 201, Fayetteville, NC 28304 Phone: 910-486-5700 | |
Ali Nasim, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3186 Village Dr 201, Fayetteville, NC 28304 Phone: 910-486-5700 |