Individual
MR. KENNETH MATTHEW YODER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
1025 W END BLVD, APT 5, WINSTON SALEM, NC 27101-2657
(828) 485-8229
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-02909
NC
Other
Enumeration date
06/04/2011
Last updated
10/28/2012
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