Individual
JOHN ANDREW SHILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-8093
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1076739
NCCPA
—
Enumeration date
01/02/2008
Last updated
04/15/2015
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