Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jun 5, 2014
License(s)
2019-01941 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 300 MEDICAL CENTER BLVD | Winston Salem, NC 27157-0003 | 336-716-3100 |
| MAILING | MEDICAL CENTER BLVD. | Winston Salem, NC 27157-0001 | 336-716-1332 |
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