Individual
VANCE BILLY MCVAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, DEPT OF ANESTHESIA MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
7264 STYERS CROSSING LN, CLEMMONS, NC 27012-8101
(336) 716-3069
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
114966
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050732
—
NC
01
—
P00243405
MEDICARE RAILROAD
NC
Enumeration date
11/21/2005
Last updated
11/13/2012
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