Individual
DANIEL PEGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
10400 MALLARD CREEK RD STE 340, CHARLOTTE, NC 28262-5203
(704) 549-9550
Mailing address
3412 VALLEY RD, WINSTON SALEM, NC 27106-2529
(405) 648-2121
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86074561
—
Other
Enumeration date
01/11/2020
Last updated
01/11/2020
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