Individual
DR. LETLHOGONOLO BENNY TLHABANO
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) 716-4649
(336) 716-9916
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4649
(336) 716-9916
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2012-00102
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2012-00102
NC
207RP1001X
Pulmonary Disease Physician
Primary
2012-00102
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100049660
—
KY
Enumeration date
11/21/2007
Last updated
09/30/2022
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