Individual
JASON HALVORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DEPT OF ORTHOPAEDIC SURGERY MEDICAL CENTER BLVD, WAKE FOREST BAPTIST HOSPITAL, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
260 LUZELLE DR, WINSTON SALEM, NC 27103-6464
(336) 529-3485
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
201301088
NC
Other
Enumeration date
06/27/2007
Last updated
06/28/2013
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