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NPI Code Detail

MEDICARE: DEIRDRE A HERRINGTON MD, LTD

MEDICARE: DEIRDRE A HERRINGTON MD, LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician25973NC

General Provider Information

NPI Number : 1811989072
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEIRDRE A HERRINGTON MD, LTD
Provider Business Mailing Address
First Line : 201 EXECUTIVE PARK BLVD
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27103-1503
Country : US
Telephone Number : 336-774-0290
Fax Number : 336-774-9012
Provider Business Practice Location Address
First Line : 201 EXECUTIVE PARK BLVD
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27103-1503
Country : US
Telephone Number : 336-774-0290
Fax Number : 336-774-9012
Authorized Official
Title or Position : PRESIDENT
Name : DEIRDRE A HERRINGTON
Credential : MD
Telephone Number : 336-774-0290
Provider Enumeration Date : 08/15/2005
Last Update Date : 11/27/2007

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