Organization
WINSTON PSYCHIATRIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJAKUMAR THOTAKURA MD (PRESIDENT)
(336) 765-6577
Entity
Organization
Contact information
Practice address
125 ASHLEYBROOK SQUARE, WINSTON SALEM, NC 27103
(336) 765-6577
(336) 768-2972
Mailing address
125 ASHLEYBROOK SQUARE, WINSTON SALEM, NC 27103
(336) 765-6577
(336) 768-2972
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0299K
BCBS
NC
05
—
890299K
—
NC
Enumeration date
11/21/2006
Last updated
08/22/2020
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