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Individual

BETHANY JULY SOUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
650 JULIAN RD, SALISBURY, NC 28147-9078
(704) 637-3373
(704) 637-0069
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200400980
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1237673
AETNA
NC
01
142TA
BCBS OF NC
NC
01
188300
MEDCOST
NC
01
3866591
CIGNA
NC
01
5710721
FIRST HEALTH
NC
05
5905046
NC
01
P00713054
RAILROAD MEDICARE
NC
Enumeration date
05/16/2006
Last updated
10/28/2020
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