Individual
DR. GRAHAM WESLEY BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-5812
(336) 716-2255
Mailing address
PO BOX 36351, SOUTHEAST ANESTHESIOLOGY CONSULTANTS PA, CHARLOTTE, NC 28236-6351
(704) 377-5772
(704) 377-3389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26624
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
26624
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8919726
—
NC
05
—
N26624
—
SC
Enumeration date
10/10/2005
Last updated
02/02/2021
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