Zwiesdak, Kelly J

Zwiesdak, Kelly J is an individual health care provider with primary practice located at 3320 Silas Creek Pkwy Suite 300, Winston Salem NC 27103-3031. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Zwiesdak, Kelly J can be contacted via phone (336) 760-2169.

Contact Information

Primary practice address
3320 Silas Creek Pkwy Suite 300 Winston Salem NC 27103-3031
Fax: (336) 760-2385
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2076 North Carolina

Profile Details

NPI number 1659330652
LBN Legal business name Zwiesdak, Kelly J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Sep 2nd, 2009 - about 15 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 1659330652 NPPES
North Carolina MEDICAID 5908843

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