Organization
SALEM PLASTIC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT L TUCKER MD (PRESIDENT)
(336) 768-8483
Entity
Organization
Contact information
Practice address
1345A WESTGATE CENTER DR, WINSTON-SALEM, NC 27103-2934
(336) 768-8483
(336) 768-1195
Mailing address
1345 WESTGATE CENTER DR STE A, WINSTON SALEM, NC 27103-3041
(336) 768-8483
(336) 768-1195
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
75404
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166U
BCBS
NC
Enumeration date
04/27/2006
Last updated
10/13/2008
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