Provider Demographics
NPI:1285098061
Name:GARNEAU, AUDREY SABRINA (MD)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:SABRINA
Last Name:GARNEAU
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 1:3821 FORRESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2930
Mailing Address - Country:US
Mailing Address - Phone:336-448-9100
Mailing Address - Fax:
Practice Address - Street 1:2614 E 7TH ST STE C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4397
Practice Address - Country:US
Practice Address - Phone:980-256-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR4070207V00000X
NC2020-00649207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology