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Individual

CONSTANCE ANN STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-7595
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-7595

Taxonomy

Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
38211
NC
207ZP0101X
Anatomic Pathology Physician
38211
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14714
PARTNERS
NC
01
220032247
RR MEDICARE
05
221714000
WV
01
4625256
AETNA
01
64248
MEDCOST
05
6601642
VA
01
79282
BCBS
05
7979282
NC
05
Q38211
SC
Enumeration date
11/30/2005
Last updated
09/23/2010
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