# DEPT OF VETERANS AFFAIRS OUTPATIENT CLINIC

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

## Provider details

- **NPI number:** 1538120910
- **Authorized official:** DR. STEPHRN BUETTLE MD (CHIEF OF STAFF)
- **Authorized official phone:** (336) 768-3296

## Contact information

- **Practice address:** 190 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
- **Practice address phone:** (336) 768-7696
- **Mailing address:** 190 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
- **Mailing address phone:** (336) 768-7696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 600091 | NC | Yes |

## Other

- **Enumeration date:** 03/28/2006
- **Last updated:** 08/22/2020