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Individual

DR. CYRUS KORESH MANAVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-7595
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-7595

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
134034
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5914514
NC
Enumeration date
11/12/2007
Last updated
11/18/2010
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