Individual
JOHN GREGORY LYALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1381 WESTGATE CENTER DR, WINSTON SALEM, NC 27103-2934
(336) 718-0100
(336) 718-0120
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-0100
(336) 718-0120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2007-00989
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417165903
—
NC
Enumeration date
05/18/2007
Last updated
10/25/2020
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