Healthcare Provider Details

I. General information

NPI: 1538955422
Provider Name (Legal Business Name): LYDIA SWAIM ARAUJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SILAS CREEK PKWY
WINSTON SALEM NC
27103-3013
US

IV. Provider business mailing address

206 W LEBANON ST
MOUNT AIRY NC
27030-2938
US

V. Phone/Fax

Practice location:
  • Phone: 336-718-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number314349
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: