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Organization
WINECOFF FAMILY PRACTICE PLLC
Active
Organization
WINECOFF FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAN A VAN RAVESTEYN MD (PHYSICIAN OWNER)
(704) 262-7901
Entity
Organization
Contact information
Practice address
304 WINECOFF SCHOOL RD, CONCORD, NC 28027
(704) 262-7901
(704) 262-7902
Mailing address
304 WINECOFF SCHOOL RD, CONCORD, NC 28027
(704) 262-7901
(704) 262-7902
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9701631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1208V
BCBS
NC
05
—
891208V
—
NC
Enumeration date
04/20/2006
Last updated
08/22/2020
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