| Summit Sleep Disorder Center, Pa | |
|
160 Charlois Blvd Winston Salem NC 27103-1522 | |
| (336) 768-5834 | |
| (336) 765-4889 |
| Full Name | Summit Sleep Disorder Center, Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Sleep Medicine |
| Location | 160 Charlois Blvd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Patricia C Pulliam (VICE PRESIDENT ADMINISTRATION) |
| Authorized Official Contact | 3367685834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Sleep Disorder Center, Pa 160 Charlois Blvd Winston Salem NC 27103-1522 Ph: (336) 768-5834 | Summit Sleep Disorder Center, Pa 160 Charlois Blvd Winston Salem NC 27103-1522 Ph: (336) 768-5834 |
| NPI Number | 1205968963 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 12/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205968963 | NPI | - | NPPES |
| 210527C | Other | NC | MEDICARE |
| 01151 | Other | NC | BCBSOFNC |
| 7901151 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | 19652 (North Carolina) | Primary |
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