Individual
RYAN T MOTT
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) 716-7595
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-7595
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
2006-00688
NC
207ZP0101X
Anatomic Pathology Physician
Primary
2006-00688
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10387655
—
VA
01
—
142RT
BCBS
NC
01
—
190060
MEDCOST
NC
05
—
3810010736
—
WV
05
—
5904512
—
NC
01
—
7306888
AETNA
NC
01
—
808488
PARTNERS
NC
05
—
Q0068P
—
SC
Enumeration date
07/18/2006
Last updated
08/20/2010
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