Individual
JAO OU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2016-00675
NC
Other
Enumeration date
04/06/2010
Last updated
10/11/2016
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