Individual
BRYSON LEE STILWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1695 KERNERSVILLE MEDICAL PKWY, KERNERSVILLE, NC 27284-7159
(336) 515-5000
Mailing address
1695 KERNERSVILLE MEDICAL PKWY, KERNERSVILLE, NC 27284-7159
(336) 515-5000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-04765
NC LICENSE
NC
Enumeration date
01/06/2014
Last updated
08/26/2020
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