Provider Demographics
NPI:1043399835
Name:FIELDS, VALERIE JEANETTE (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEANETTE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 FEDERAL DR
Mailing Address - Street 2:SUITE1
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8148
Mailing Address - Country:US
Mailing Address - Phone:336-315-6270
Mailing Address - Fax:336-235-0435
Practice Address - Street 1:4380 FEDERAL DR
Practice Address - Street 2:SUITE1
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8148
Practice Address - Country:US
Practice Address - Phone:336-315-6270
Practice Address - Fax:336-235-0435
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74518207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42883XMedicare ID - Type Unspecified
FLG63916Medicare UPIN