Individual
LARRY KEITH CANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 HIGHLAND OAKS DR, SUITE 201, WINSTON SALEM, NC 27103-7106
(336) 765-0020
(336) 765-0581
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 765-0020
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
24230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001
PARTNERS
NC
01
—
127FN
BLUE CROSS
NC
05
—
3002077000
—
WV
01
—
4098171
AETNA
NC
05
—
5850215
—
VA
05
—
89127FN
—
NC
01
—
A0333
MEDCOST
NC
05
—
Q24230
—
SC
Enumeration date
12/08/2005
Last updated
06/27/2013
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