Provider Demographics
NPI:1689758831
Name:GREFE, ANNETTE (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:GREFE
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:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27102-0344
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-9016
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:336-716-9016
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCT90-012922084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
143XNOtherBCBS
NC5906437Medicaid
WV3810008069Medicaid
5155674OtherAETNA
808935OtherPARTNERS
VA1689758831Medicaid
SCQ01773Medicaid
192881OtherMEDCOST
NC5906437Medicaid
VA1689758831Medicaid