Organization
SUMMIT SLEEP DISORDER CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA C PULLIAM (VICE PRESIDENT ADMINISTRATION)
(336) 768-5834
Entity
Organization
Contact information
Practice address
160 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1522
(336) 768-5834
(336) 765-4889
Mailing address
160 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1522
(336) 768-5834
(336) 765-4889
Taxonomy
Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
19652
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01151
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
03/22/2007
Last updated
08/22/2020
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