Individual
THOMAS MCCONNELL MCCUTCHEN
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
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200300662
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
200300662
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10014158
—
VA
01
—
1338H
BCBS
NC
05
—
196175
—
SC
05
—
3004331000
—
WV
01
—
4523771
AETNA
—
01
—
802892
PARTNERS
NC
05
—
891338H
—
NC
01
—
C6419
MEDCOST
NC
Enumeration date
12/13/2005
Last updated
09/08/2017
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