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Individual

KALIYANN TE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-3736
(336) 713-4500
(336) 713-4501
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04770
NC
363A00000X
Physician Assistant
001004770
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13347760
PHCS-MULTIPLAN
NC
01
1356764690
HUMANA
NC
05
1356764690
NC
01
1458919
COVENTRY OF THE CAROLINAS
NC
01
185TD
BCBS OF NC
NC
01
250511
MEDCOST
NC
01
3819841
UNITED HEALTHCARE
NC
01
4293725
COVENTRY NATIONAL - COVENTRY PPO
NC
01
4952804
AETNA
NC
01
6877441
CIGNA-GREATWEST
NC
01
FH4001665
FIRST CAROLINA CARE
NC
Enumeration date
01/22/2014
Last updated
01/03/2025
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