Individual
ELIZABETH LEONILA PALAVECINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
207ZM0300X
Medical Microbiology Physician
Primary
200301032
NC
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
200301032
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10017807
—
VA
01
—
1341V
BCBS
NC
05
—
2005694000
—
WV
01
—
7067670
AETNA
NC
01
—
803319
PARTNERS
NC
05
—
891341V
—
NC
01
—
C8207
MEDCOST
NC
Enumeration date
11/30/2005
Last updated
08/23/2010
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