Individual
MR. DAVID RICHARD COURTEMANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
3734 REYNOLDA RD, WINSTON SALEM, NC 27106-2240
(336) 922-1102
(336) 922-5012
Mailing address
3069 TRENWEST DR, STE 200, WINSTON SALEM, NC 27103-3211
(336) 922-1102
(336) 922-5012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102629
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153YJ
BCBS
NC
05
—
8102968
—
NC
Enumeration date
02/05/2007
Last updated
05/19/2014
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