Individual
CALLISTA ROSE ADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-2128
(336) 716-2255
Mailing address
501 GREENE FARM TRL, VILAS, NC 28692-9779
(919) 812-5303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11558
NC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/09/2021
Last updated
10/27/2022
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