Individual
DR. MANOJ PARIYADATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
500572
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10413559
—
VA
01
—
1396C
BCBS
NC
01
—
190062
MEDCOST
NC
05
—
3810008137
—
WV
05
—
5901203
—
NC
01
—
7565671
AETNA
—
01
—
808490
PARTNERS
—
05
—
N0057F
—
SC
Enumeration date
07/04/2006
Last updated
08/18/2010
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