Individual
SURESH JILLELLAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 LYNDHURST AVE, WINSTON SALEM, NC 27103-4007
(336) 765-0383
(336) 760-6918
Mailing address
3001 LYNDHURST AVE, WINSTON SALEM, NC 27103-4007
(336) 765-0383
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2020-04806
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2020-04806
NC
207RI0200X
Infectious Disease Physician
2020-04806
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080858
—
WA
Enumeration date
07/23/2008
Last updated
03/08/2023
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