Individual
DEMETRIA ILEANA STRAUCH JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 277-8800
Mailing address
PO BOX 75216, CHARLOTTE, NC 28275-0216
(336) 277-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL31902
SC
207RH0003X
Hematology & Oncology Physician
2015-01669
NC
207RH0003X
Hematology & Oncology Physician
ME112135
FL
207RX0202X
Medical Oncology Physician
Primary
2015-01669
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007226100
—
FL
Enumeration date
06/25/2009
Last updated
07/11/2024
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