Healthcare Provider Details

I. General information

NPI: 1124135397
Provider Name (Legal Business Name): LILIANA PANTEA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILIANA RIVIS M.D.

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 BETHANIA RURAL HALL RD
RURAL HALL NC
27045-9552
US

IV. Provider business mailing address

100 KIMEL FOREST DR
WINSTON SALEM NC
27103-6074
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-9270
  • Fax:
Mailing address:
  • Phone: 336-713-0947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number017796
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2016-02252
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberEC081002
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: