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Individual

JOHN PETER BIRKEDAL

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
(336) 716-8018
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8018

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
200101424
NC
207XS0117X
Orthopaedic Surgery of the Spine Physician
200101424
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1307J
BCBS
05
2005250000
WV
01
49021
PARTNERS
05
6407480
VA
01
7023675
AETNA
05
891307J
NC
01
B6450
MEDCOST
Enumeration date
11/30/2005
Last updated
11/15/2010
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