Individual
MARY ALYCE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL CENTER BLVD, DEPARTMENT OF SURGERY, WINSTON SALEM, NC 27101-1148
(336) 716-4396
Mailing address
1 MEDICAL CENTER BLVD, DEPARTMENT OF SURGERY, WINSTON SALEM, NC 27101-1148
(336) 716-4396
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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