Individual
WILLIAM PYLE BOZEMAN
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
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200300751
NC
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
200300751
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10027942
—
VA
01
—
134VR
BCBS
—
05
—
2005887000
—
WV
01
—
5780323
AETNA
—
01
—
803318
PARTNERS
—
05
—
89134VR
—
NC
01
—
C8204
MEDCOST
—
05
—
Q0075D
—
SC
Enumeration date
12/23/2005
Last updated
06/28/2010
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