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Individual

PHYLLIS K NYINAKU-YEBOAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101243599
VA
207R00000X
Internal Medicine Physician
200501371
NC
208M00000X
Hospitalist Physician
Primary
0101243599
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5902061
NC
Enumeration date
03/20/2006
Last updated
05/06/2015
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