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Individual

BOBBY D WITTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10188 N MAIN ST, ARCHDALE, NC 27263-2906
(336) 802-2070
(336) 802-2071
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014-01181
NC
207Q00000X
Family Medicine Physician
K9704
TX
208D00000X
General Practice Physician
2014-01181
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0064EJ
BCBS
TX
05
092429201
TX
05
092429202
TX
Enumeration date
07/26/2005
Last updated
11/29/2023
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