Individual
MRS. CAROLYN VENICE MARCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPH
Contact information
Practice address
799 HIGHLAND AVE, WINSTON SALEM, NC 27101-4206
(336) 703-3100
(336) 727-8135
Mailing address
PO BOX 686, WINSTON SALEM, NC 27102-0686
(336) 703-3100
(336) 727-8135
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
100297
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA0000038
—
NC
Enumeration date
01/25/2007
Last updated
07/08/2007
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