Individual
DR. JESSE LEE MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. MS
Contact information
Practice address
4622 COUNTRY CLUB RD STE 180, WINSTON SALEM, NC 27104-3770
(336) 768-9535
(336) 768-4155
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 768-9535
(336) 768-4155
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2017-00429
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
2017-00429
NC
Other
Enumeration date
05/06/2009
Last updated
12/30/2024
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