David Michael Vaughan

Individual provider Active NPI Pharmacist · Winston Salem, NC

NPI 1821453069 · NPPES record last updated Dec 15, 2015

Key facts

NPI
1821453069
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
15533 (NC)
Practice address
4340 Old Lexington Rd
Winston Salem, NC 27107-9408
Phone
(336) 650-1799
NPI assigned
Dec 15, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15533NCMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15533 NC Yes

Addresses

Primary practice location

4340 Old Lexington Rd
Winston Salem, NC 27107-9408

Mailing address

4340 Old Lexington Rd
Winston Salem, NC 27107-9408
Phone (336) 650-1799

Other providers in Winston Salem, NC

All providers in Winston Salem, NC · Pharmacist in North Carolina

Sources for this page

Verify at the official NPI Registry.