Individual
SHIVA JARRAHI KINCAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1930 NORTH PEACE HAVEN RD, WINSTON SALEM, NC 27106-4817
(336) 716-2255
(336) 760-0254
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 760-0254
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
96-01195
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7911398
—
NC
Enumeration date
08/16/2005
Last updated
06/16/2010
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