Individual
THOMAS DURWARD DUBOSE JR.
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, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200201240
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132YH
BCBS
NC
05
—
3810002109
—
WV
01
—
4514540
AETNA
NC
05
—
5881668
—
VA
01
—
801321
PARTNERS
NC
05
—
89132YH
—
NC
01
—
C0870
MEDCOST
NC
05
—
Q0124C
—
SC
Enumeration date
11/28/2005
Last updated
03/13/2025
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