Individual
JOHN DAVID REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
791 JONESTOWN RD, WINSTON SALEM, NC 27103-1252
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
93-00294
NC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
93-00294
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8970991
—
NC
Enumeration date
01/06/2006
Last updated
11/12/2012
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