Organization
HUGO A TETTAMANTI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUGO A TETTAMANTI M.D. (OWNER)
(336) 760-4846
Entity
Organization
Contact information
Practice address
2928 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4021
(336) 760-4846
(336) 760-6462
Mailing address
2928 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4021
(336) 760-4846
(336) 760-6462
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
18235
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011VJ
BCBSNC
NC
05
—
89011VJ
—
NC
01
—
DE8018
RAILROAD MEDICARE
NC
Enumeration date
09/25/2006
Last updated
09/24/2007
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