Individual
LORETTA LEE MUCHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
MEDICAL CENTER BLVD., NEUROSURGERY, WINSTON-SALEM, NC 27157-0001
(367) 164-0813
(336) 716-3065
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5016673
NC
207T00000X
Neurological Surgery Physician
5016673
NC
363L00000X
Nurse Practitioner
Primary
5016673
NC
Other
Enumeration date
08/12/2022
Last updated
03/02/2023
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