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General NPI Number Information
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NPI Number | 1497964969
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Entity Type | Individual
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Provider Name | JOHN D CLINGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 336-716-4161
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Fax | 336-716-9440
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Provider Business Mailing Address
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Address Line | PO BOX 602658
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City | CHARLOTTE
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State | NC
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Zip | 28260-2658
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Country | US
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Telephone | 336-716-2011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2012-00928
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License Number State | NC
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