Individual
DR. TIM DAVIS WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 W 4TH ST STE 600, WINSTON SALEM, NC 27101-3816
(336) 306-5777
(336) 999-8889
Mailing address
PO BOX 30369, WINSTON SALEM, NC 27130-0369
(336) 999-8888
(336) 999-8889
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
33929
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220016574
RAILROAD MEDICARE
—
01
—
86073
BCBS OF NC
NC
05
—
8986073
—
NC
Enumeration date
08/22/2005
Last updated
10/03/2022
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