Individual
DANIELLE CARUSO REBOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 KIMEL PARK DR, SUITE 330, WINSTON SALEM, NC 27103-6984
(336) 765-6181
(336) 765-8492
Mailing address
145 KIMEL PARK DR, SUITE 330, WINSTON SALEM, NC 27103-6984
(336) 765-6181
(336) 765-8492
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04354
NC
363A00000X
Physician Assistant
PA200309
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1806587
—
LA
Enumeration date
10/15/2009
Last updated
12/09/2013
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