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1750887915
NICOLE MARIE LAWING KOUTLAS
WINSTON SALEM, NC
NPI
1750887915
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207K00000X Allergy & Immunology
(Licence: NC 2021-01464)
Enumeration Date
2018-04-04
Last Update Date
2023-10-31
Business Address
NICOLE MARIE LAWING KOUTLAS MD
1372 WESTGATE CENTER DR
WINSTON SALEM, NC 27103-2932
Phone number: 336-659-4814
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Mailing Address
NICOLE MARIE LAWING KOUTLAS MD
PO BOX 603725
CHARLOTTE, NC 28260-3725
Phone number: 828-575-2625
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