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Individual

JOHN H MYRACLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
114 KINDERTON BLVD, ADVANCE, NC 27006-7302
(336) 998-9742
(336) 998-9410
Mailing address
1701 WESTCHESTER DRIVE, SUITE 850, HIGH POINT, NC 27262-7254
(336) 802-2536
(336) 802-2534

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22603
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8961727
NC
Enumeration date
02/27/2006
Last updated
12/28/2012
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