Individual
IZZAH VASIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
250 HOSPITAL DR, LEXINGTON, NC 27292-6792
(336) 248-5161
(336) 716-0030
Mailing address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101286425
VA
208M00000X
Hospitalist Physician
2019-02369
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568812485
WAKE FOREST BAPTIST MEDICAL CENTRE
—
Enumeration date
06/22/2016
Last updated
09/03/2025
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