Individual
DR. MYRON SHEAVICTOR POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-6637
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2012-01042
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920407
—
NC
Enumeration date
01/02/2008
Last updated
01/28/2013
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