Organization
DEPT OF VETERANS AFFAIRS OUTPATIENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHRN BUETTLE MD (CHIEF OF STAFF)
(336) 768-3296
Entity
Organization
Contact information
Practice address
190 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
(336) 768-7696
Mailing address
190 KIMEL PARK DR, WINSTON-SALEM, NC 27103-6946
(336) 768-7696
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
600091
NC
Other
Enumeration date
03/28/2006
Last updated
08/22/2020
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