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Individual

RICHARD KAZIBWE

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
8 FLAGSHIP CIR, C/O WALTER LIEBKEMANN, GREENSBORO, NC 27455-3429
(336) 707-0349

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101259279
VA
207R00000X
Internal Medicine Physician
191452
NC
208M00000X
Hospitalist Physician
Primary
2020-00473
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101259279
LICENSE
VA
Enumeration date
06/17/2013
Last updated
11/18/2020
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