Individual
NE WIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MB BS
Contact information
Practice address
2300 RAMSEY ST, FAYETTEVILLE, NC 28301-3856
(910) 488-2120
Mailing address
2300 RAMSEY ST, FAYETTEVILLE, NC 28301-3856
(910) 488-2120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TL002283
GA
Other
Enumeration date
09/13/2007
Last updated
06/20/2024
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