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Individual

SOROUSH RAIS-BAHRAMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
140 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1522
(336) 716-4131
(336) 713-0328
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2025-01614
NC
208800000X
Urology Physician
33402
AL

Other

Enumeration date
12/20/2011
Last updated
11/03/2025
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