Individual
DR. LAWRENCE NYCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 BETHESDA CT, WINSTON SALEM, NC 27103-3019
(336) 277-8800
(336) 277-8850
Mailing address
PO BOX 75216, CHARLOTTE, NC 28275-0216
(336) 718-7080
(336) 718-9622
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
9501622
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006005560
—
VA
01
—
0700782
UNITED HEALTHCARE
—
01
—
132A9
BLUE CROSS BLUE SHIELD
NC
01
—
3098889
AETNA HMO
—
01
—
7627370
AETNA PPO
—
01
—
800220
PARTNERS NATIONAL HEALTH
NC
05
—
89132A9
—
NC
01
—
B8416
MEDCOST
—
01
—
P00031287
RAILROAD MEDICARE
—
Enumeration date
01/23/2006
Last updated
10/29/2020
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