Individual
JOSEPH GEORGES DAKERMANDJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-6338
(336) 716-4649
(336) 716-9916
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4649
(336) 716-9916
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12289
NC
363A00000X
Physician Assistant
0110003479
VA
363A00000X
Physician Assistant
2313
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2199PA
—
SC
Enumeration date
03/03/2011
Last updated
08/04/2022
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