# LANCET RHEUMATOLOGY AND SARA LUPUS CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194173633
- **Authorized official:** NILAMADHAB MISHRA MD (ORGANIZER AND MEMBER)
- **Authorized official phone:** (336) 918-3421

## Contact information

- **Practice address:** 275 EXECUTIVE PARK BLVD STE 601, WINSTON SALEM, NC 27103
- **Practice address phone:** (336) 955-1838
- **Practice address fax:** (336) 955-1842
- **Mailing address:** 275 EXECUTIVE PARK BLVD STE 601, WINSTON SALEM, NC 27103-1548
- **Mailing address phone:** (336) 955-1838
- **Mailing address fax:** (336) 955-1842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | 200000903 | NC | Yes |

## Other

- **Enumeration date:** 05/25/2016
- **Last updated:** 07/23/2018