Individual
CHASE COUNTRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 713-9100
Mailing address
1 MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 713-9100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
261564
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2020
Last updated
07/20/2022
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