Individual
ASHLEY MANER TONIDANDEL
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) 716-8190
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8190
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200401341
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
200401341
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146F6
BCBS
—
01
—
202027
MEDCOST
—
05
—
3810009593
—
WV
05
—
5907505
—
NC
01
—
810638
PARTNERS
—
01
—
9941091
AETNA
—
05
—
Q41004
—
SC
Enumeration date
05/21/2007
Last updated
09/11/2017
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