Individual
DIXON MCGUIRE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
19074
NC
2085R0204X
Vascular & Interventional Radiology Physician
19074
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10655
PARTNERS
NC
05
—
194324000
—
WV
01
—
4604087
AETNA
NC
01
—
60105
BCBS
NC
01
—
64184
MEDCOST
NC
05
—
7230273
—
VA
05
—
8960105
—
NC
05
—
Q19074
—
SC
Enumeration date
12/01/2005
Last updated
05/15/2008
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