SIDNEY WILSON LAVENDER

WINSTON SALEM, NC
NPI1609859313
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: NC  000100189)
Enumeration Date2005-11-28
Last Update Date2010-08-20
Business Address
-- SIDNEY WILSON LAVENDER PAC
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157-0001
Phone number: 336-716-2255
Mailing Address
-- SIDNEY WILSON LAVENDER PAC
PO BOX 344
WINSTON SALEM, NC 27102-0344
Phone number: 336-716-2255
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