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Individual

DR. RYAN LEE MCKIMMIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1901 S HAWTHORNE RD, SUITE 310, WINSTON SALEM, NC 27103-3921
(336) 448-2427
(336) 765-2869
Mailing address
1830 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4014
(336) 448-2427
(336) 765-2869

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007-01544
NC
207RG0100X
Gastroenterology Physician
Primary
2007-01544
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5911896
NC
Enumeration date
09/14/2007
Last updated
11/27/2023
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