Individual
DR. VICKAS KHEMSARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1710 SOUTH HAWTHORNE RD, SUMMIT EYE CARE, WINSTON SALEM, NC 27103-4016
(336) 765-0960
(336) 765-7453
Mailing address
1710 S HAWTHORNE RD, SUMMIT EYE CARE, WINSTON SALEM, NC 27103-4016
(336) 765-0960
(336) 765-7453
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01566
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01566
ST LICENSE
NC
01
—
10584171
CAQH
—
05
—
5910540
—
NC
Enumeration date
06/10/2005
Last updated
04/06/2010
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