Doctor Name: | MELISSA ANN WINTERS |
NPI Number: | 1023092566 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | 000101525 |
Business Practice Address: | Medical Center Blvd Winston-salem, NC - 27157 |
Business Phone Number: | 3367162255 |
Business Fax Number: | |
Mailing Address: | Po Box 602658, CHARLOTTE |
State: | NC |
Postal Code: | 282602658 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/29/2005 |
NPI Last Update Date: | 06/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 000101525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |