Organization
CHANDA A. GRIESSEL M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANDA ANNETTE GRIESSEL M.D. (MANAGER)
(336) 760-2240
Entity
Organization
Contact information
Practice address
150 KIMEL PARK DR, SUITE 200, WINSTON SALEM, NC 27103-6992
(336) 760-2240
(336) 760-2239
Mailing address
150 KIMEL PARK DR, SUITE 200, WINSTON SALEM, NC 27103-6992
(336) 760-2240
(336) 760-2239
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
200301236
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950669
—
NC
Enumeration date
12/07/2007
Last updated
06/28/2012
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