Individual
MICHAEL A BETTMANN
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
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
200500159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10196728
—
VA
01
—
1381M
BCBS
—
05
—
5901470
—
NC
01
—
7693656
AETNA
—
01
—
805574
PARTNERS
—
01
—
E0802
MEDCOST
—
05
—
Q0015G
—
SC
Enumeration date
12/02/2005
Last updated
02/09/2012
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