Individual
ELVY PETTIT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3080 TRENWEST DR, THE SALEM CENTER, WINSTON SALEM, NC 27103-3208
(336) 768-0496
(336) 768-0498
Mailing address
3080 TRENWEST DR, THE SALEM CENTER, WINSTON SALEM, NC 27103-3208
(336) 768-0496
(336) 768-0498
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101961
NC
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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