Organization
RISE UP ADDICTION MEDICINE & PAIN MANAGEMENT PLLC
Active
Other names
Medical Office
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ROYALL JR. FNP (OWNER)
(336) 248-1068
Entity
Organization
Contact information
Practice address
500 W 5TH ST STE 800, WINSTON SALEM, NC 27101-3131
(336) 247-1068
Mailing address
500 W 5TH ST STE 800, WINSTON SALEM, NC 27101-3131
(336) 247-1068
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356819320
—
NC
Enumeration date
07/14/2021
Last updated
09/08/2021
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