Individual
DR. JOHN MODARRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3960 WHITE HAWK LN, WINSTON SALEM, NC 27106-2666
(336) 922-3440
Mailing address
3960 WHITE HAWK LN, WINSTON SALEM, NC 27106-2666
(336) 922-3440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35027
NC
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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