Individual
GRANT W MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-3013
Mailing address
200 QUEENS RD STE 400, CHARLOTTE, NC 28204-3264
(704) 765-2578
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2024-00919
NC
2085R0203X
Therapeutic Radiology Physician
R5143
KY
Other
Enumeration date
04/03/2017
Last updated
06/12/2024
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