Individual
RAYMOND CLYDE ROY
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
22435
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
22435
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10576
BCBS
—
01
—
24400
PARTNERS
—
01
—
50086397
RR MEDICARE
—
05
—
5715857
—
VA
05
—
62139000
—
WV
01
—
7879344
AETNA
—
05
—
7910576
—
NC
01
—
80509
MEDCOST
—
05
—
L17462
—
SC
Enumeration date
12/13/2005
Last updated
08/19/2010
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