Individual
CAROL LOGAN VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-4500
(336) 713-4501
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
2016-01060
NC
390200000X
Student in an Organized Health Care Education/Training Program
183249
NC
Other
Enumeration date
05/18/2012
Last updated
08/22/2023
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