Healthcare Provider Details

I. General information

NPI: 1033162557
Provider Name (Legal Business Name): CHIRAPA SINTHUSEK, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 HIGHLAND OAKS DR SUITE 101
WINSTON-SALEM NC
27103-7108
US

IV. Provider business mailing address

730 HIGHLAND OAKS DR SUITE 101
WINSTON-SALEM NC
27103-7108
US

V. Phone/Fax

Practice location:
  • Phone: 336-765-6897
  • Fax: 336-765-7306
Mailing address:
  • Phone: 336-765-6897
  • Fax: 336-765-7306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number18717
License Number StateNC

VIII. Authorized Official

Name: DR. CHIRAPA SINTHUSEK
Title or Position: OWNER
Credential: MD
Phone: 336-765-6897