Healthcare Provider Details

I. General information

NPI: 1316043763
Provider Name (Legal Business Name): NANCY MARIE DENIZARD-THOMPSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY DENIZARD MD

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BLVD
WINSTON-SALEM NC
27157
US

IV. Provider business mailing address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-713-9800
  • Fax:
Mailing address:
  • Phone: 336-713-4156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2006-01143
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: