Organization
SALEM SURGICAL ASSOCS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L BUNKER (ADMINISTRATOR)
(336) 794-8622
Entity
Organization
Contact information
Practice address
2915 LYNDHURST AVE, WINSTON SALEM, NC 27103-4005
(336) 765-5221
Mailing address
2915 LYNDHURST AVE, WINSTON SALEM, NC 27103-4005
(336) 765-5221
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902593
—
NC
Enumeration date
04/21/2006
Last updated
07/10/2007
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