Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 200500458 | NC |
Y | 111NI0900X | Internist | 200500458 | NC |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 2005-00452 | NC |
NPI | 1043281033 |
---|---|
Provider Name | Claudia Campos |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 21/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H68018 | (02) |