Individual
MR. JOHN ZACHARY RUIZ LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-5000
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-3550
(336) 277-6981
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0010-08871
NC
2084P0800X
Psychiatry Physician
0010-08871
NC
2084P0802X
Addiction Psychiatry Physician
0010-08871
NC
2084P0804X
Child & Adolescent Psychiatry Physician
0010-08871
NC
363A00000X
Physician Assistant
Primary
0010-08871
NC
Other
Enumeration date
11/26/2018
Last updated
03/28/2019
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