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Individual

EDWARD LANCE KREGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-5663
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02341
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8102112
NC
Enumeration date
06/11/2010
Last updated
12/15/2017
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