Individual
JESSICA SON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
204 OAKWOOD CT, WINSTON SALEM, NC 27103-1955
(919) 264-5807
Mailing address
8512 OLD DEER TRL, RALEIGH, NC 27615-2944
(919) 264-5807
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
2016-00763
NC
390200000X
Student in an Organized Health Care Education/Training Program
182916
NC
Other
Enumeration date
05/11/2012
Last updated
08/31/2016
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