Individual
DR. CLINTON REYES SORIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 S HAWTHORNE RD, SUITE 340, WINSTON SALEM, NC 27103-3921
(336) 765-6277
(336) 659-0449
Mailing address
1901 S HAWTHORNE RD, SUITE 340, WINSTON SALEM, NC 27103-3921
(336) 765-6277
(336) 659-0449
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4136089
AETNA
—
05
—
8978420
—
NC
Enumeration date
04/27/2006
Last updated
11/25/2008
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