Individual
JAIME JEYUSON JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-8383
(336) 718-9622
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-8383
(336) 718-9622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009-00019
NC
208M00000X
Hospitalist Physician
Primary
2009-00019
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1511C
BCBSNC
NC
05
—
5911075
—
NC
Enumeration date
05/14/2008
Last updated
08/17/2021
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