Individual
WILLIAM MCCANDLESS PETTY
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
207VX0201X
Gynecologic Oncology Physician
Primary
2006-00960
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10186579
—
VA
01
—
140AP
BCBS
—
01
—
212133
MEDCOST
—
05
—
3810002778
—
WV
05
—
5905804
—
NC
01
—
7391773
AETNA
—
01
—
806776
PARTNERS
—
01
—
P00416726
RR MEDICARE
—
05
—
Q0059L
—
SC
Enumeration date
01/24/2007
Last updated
08/18/2010
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