Healthcare Provider Details

I. General information

NPI: 1043690985
Provider Name (Legal Business Name): VICTORIA LYNNETTE WINNINGHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA BELCHER M.D.

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD BALCONY SUITE 5
GREENVILLE SC
29605-4210
US

IV. Provider business mailing address

15 SHADELL LN
MAYFLOWER AR
72106-9000
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-7895
  • Fax: 864-455-7807
Mailing address:
  • Phone: 501-697-1922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL38142
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberE-13198
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: