Individual
MEDGE DENISE OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
207L00000X
Anesthesiology Physician
Primary
9400119
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
9400119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001337
—
WV
05
—
5701694
—
VA
01
—
63974
MEDCOST
NC
01
—
64431
BCBS
NC
05
—
7003887
—
NC
01
—
7775333
AETNA
—
01
—
8248
PARTNERS
NC
Enumeration date
12/13/2005
Last updated
09/08/2017
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