Individual
MICHELLE ELIZABETH DE WITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
190 KIMEL PARK DR STE 155, WINSTON SALEM, NC 27103-6946
(336) 765-6637
(336) 765-6964
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2023-01520
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2016
Last updated
07/10/2023
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