Individual
DR. ANDORA LYNN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-8190
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8190
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2006-00547
NC
207R00000X
Internal Medicine Physician
2006-00547
NC
208000000X
Pediatrics Physician
2006-00547
NC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2006-00547
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904203
—
NC
Enumeration date
07/27/2006
Last updated
06/17/2025
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