Individual
SHAYNE ETHAN BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3746 VEST MILL RD, WINSTON SALEM, NC 27103-2912
(336) 716-2255
(336) 774-0707
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 774-0707
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2010-01033
NC
Other
Enumeration date
10/26/2007
Last updated
09/28/2010
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