Provider Demographics
NPI:1811954845
Name:AMUNDSON C SILVA, BROOK ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:BROOK
Middle Name:ELIZABETH
Last Name:AMUNDSON C SILVA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:719 GREEN VALLEY RD
Mailing Address - Street 2:101
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7014
Mailing Address - Country:US
Mailing Address - Phone:336-370-0227
Mailing Address - Fax:336-333-9757
Practice Address - Street 1:719 GREEN VALLEY RD
Practice Address - Street 2:#101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7014
Practice Address - Country:US
Practice Address - Phone:336-370-0277
Practice Address - Fax:336-333-9757
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCNC200000174207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014FVMedicaid
NCNCF835A338Medicare PIN
NC89014FVMedicaid