Healthcare Provider Details

I. General information

NPI: 1821582099
Provider Name (Legal Business Name): YASMINE KAHOK ALIMENA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 LEWISVILLE CLEMMONS RD
CLEMMONS NC
27012-7462
US

IV. Provider business mailing address

100 KIMEL FOREST DR
WINSTON SALEM NC
27103-6074
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-8575
  • Fax: 336-702-9265
Mailing address:
  • Phone: 336-713-0947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2021-01584
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: