Individual
JACK XU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
186 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(336) 277-2000
(336) 277-2050
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(336) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2022-01767
NC
207R00000X
Internal Medicine Physician
E-12710
AR
Other
Enumeration date
08/15/2016
Last updated
03/22/2023
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