Individual
BARRY R DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4195
(336) 716-3202
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4195
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
2013-00575
NC
207ZP0101X
Anatomic Pathology Physician
33078
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0218479
—
IA
05
—
1218479
—
IA
05
—
1518955319
—
NC
01
—
22079
WELLMARK BCBS
IA
01
—
33932
WELLMARK BCBS
IA
Enumeration date
10/06/2005
Last updated
02/06/2014
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