Individual
LURA W STAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2909 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4009
(336) 794-3380
Mailing address
2909 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4009
(336) 794-3380
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0016021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8911986
—
NC
Enumeration date
06/04/2006
Last updated
07/08/2007
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