Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 2019-00844 | NC |
NPI | 1386290211 |
---|---|
Provider Name | Dr. Komal Bahadur Gurung |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2019 |
Last Update Date | 15/08/2019 |