Individual
MADISON LYNN WYLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 HANESTOWN CT STE 151, WINSTON SALEM, NC 27103-1749
(336) 765-9350
Mailing address
111 HANESTOWN CT STE 151, WINSTON SALEM, NC 27103-1749
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-14818
NC
Other
Enumeration date
06/16/2025
Last updated
08/05/2025
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