Individual
DUDLEY ELLIOTT HAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, DEPARTMENT OF PEDIATRICS, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-5599
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
2008-01125
NC
208000000X
Pediatrics Physician
Primary
2008-01125
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5910056
—
NC
Enumeration date
08/06/2008
Last updated
09/05/2017
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