Individual
CODY ADAM MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5093 UNIVERSITY PKWY, WINSTON SALEM, NC 27106-6085
(336) 883-0029
Mailing address
645 N MAIN ST, HIGH POINT, NC 27260-5017
(336) 883-0029
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
0010-09573
NC
363A00000X
Physician Assistant
Primary
0010-09573
NC
Other
Enumeration date
10/03/2019
Last updated
07/19/2024
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