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Organization
DEPT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Active
Organization
DEPT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHRN BUETTLE MD (CHIEF OF STAFF)
(336) 768-3296
Entity
Organization
Contact information
Practice address
190 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
(336) 768-7696
Mailing address
190 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
(336) 768-7696
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
600091
NC
Other
Enumeration date
03/28/2006
Last updated
08/22/2020
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