Individual
DEBORAH A KRETZSCHMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2006-00292
NC
207RG0100X
Gastroenterology Physician
J5063
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10411891
—
VA
01
—
142RN
BCBS
—
01
—
190044
MEDCOST
—
05
—
3810007244
—
WV
05
—
5904805
—
NC
01
—
7562857
AETNA
—
01
—
808484
PARTNERS
—
05
—
Q009D
—
SC
Enumeration date
01/17/2006
Last updated
05/29/2008
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