Pegram, Paul Samuel

Pegram, Paul Samuel is an individual health care provider with primary practice located at Medical Center Blvd , Winston Salem NC 27157-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Pegram, Paul Samuel can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
Medical Center Blvd Winston Salem NC 27157-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 16925 North Carolina

Profile Details

NPI number 1467437749
LBN Legal business name Pegram, Paul Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2005
Last updated Jan 11th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467437749 NPPES
South Carolina MEDICAID Q16925
South Carolina Other 66717
South Carolina Other 29201
South Carolina Other 5529121
South Carolina Other 3528
South Carolina MEDICAID 6010016
South Carolina MEDICAID 8966717

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