Individual
PATRICK SHAWN REYNOLDS
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) 716-2255
(336) 716-9016
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-9016
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
96 01044
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1198R
BCBS
—
01
—
130025236
RR MEDICARE
—
05
—
2004310000
—
WV
01
—
28663
PARTNERS
—
05
—
7101431
—
VA
01
—
7240386
AETNA
—
01
—
87355
MEDCOST
—
05
—
891198R
—
NC
05
—
Q01048
—
SC
Enumeration date
12/20/2005
Last updated
11/12/2010
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