Individual
MR. FREDERICK KEITH STIREWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MEDICAL CENTER BLVD FAITHHEALTH, WINSTON SALEM, NC 27157-0001
(336) 716-5811
Mailing address
MEDICAL CENTER BLVD FAITHHEALTH, WINSTON SALEM, NC 27157-0001
(336) 716-5811
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
100767
NC
363A00000X
Physician Assistant
Primary
100767
NC
Other
Enumeration date
09/13/2018
Last updated
02/22/2019
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