Individual
JASON D CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2002-00669
NC
207RG0100X
Gastroenterology Physician
Primary
2002-00669
NC
207RI0008X
Hepatology Physician
2002-00669
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10389755
—
VA
01
—
1318R
BCBS
NC
01
—
190034
MEDCOST
NC
05
—
3810007317
—
WV
01
—
7520309
AETNA
NC
01
—
808471
PARTNERS
NC
05
—
891318R
—
NC
Enumeration date
07/03/2006
Last updated
04/24/2008
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