Individual
DR. ANDREW GRAY BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD, WAKE FOREST BAPTIST MEDICAL CENTER, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
32654
NC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
32654
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12338
PARTNERS
—
01
—
1516879-003
CIGNA
—
01
—
19674
BCBS
NC
01
—
2460072/5678036
AETNA
—
01
—
290005714
RAILROAD MEDICARE
—
01
—
298485
MAMSI
—
01
—
311001
COVENTRY
—
01
—
32654
NC MEDICAL BOARD
NC
01
—
4840048
UNITED HEALTHCARE
—
05
—
890109N
—
NC
Enumeration date
04/03/2006
Last updated
03/07/2023
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