Individual
MATTHEW DOUGLAS REGISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
145 KIMEL PARK DR, SUITE 120, WINSTON SALEM, NC 27103-6984
(336) 768-3212
Mailing address
145 KIMEL PARK DR, SUITE 120, WINSTON SALEM, NC 27103-6984
(336) 768-3212
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024171858
VA
367500000X
Certified Registered Nurse Anesthetist
235447
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
R179771
MD
Other
Enumeration date
08/20/2013
Last updated
10/16/2025
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