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Individual

MARGUERITE T TENNILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2808 MAPLEWOOD AVE, WINSTON-SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702
Mailing address
2808 MAPLEWOOD AVE, WINSTON-SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27002
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8988384
NC
Enumeration date
08/09/2005
Last updated
03/07/2023
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