Basic Information
| Provider Information | |||||||||
| NPI: | 1225134323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LITTLE | ||||||||
| FirstName: | ALFRED | ||||||||
| MiddleName: | BOYD | ||||||||
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| Credential: | MD FACC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3200 NORTHLINE AVE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274087616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362737900 | ||||||||
| FaxNumber: | 3362738147 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 NORTHLINE AVE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274087616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362737900 | ||||||||
| FaxNumber: | 3362738147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 08/18/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 23900 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 8952112 | 05 | NC | MEDICAID | 52112 | 01 | NC | BCBS NC | OTHER |