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General NPI Number Information
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NPI Number | 1730220963
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Entity Type | Individual
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Provider Name | CECIL DWIGHT PRICE M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | WAKE FOREST UNIVERSITY - 1834 REYNOLDA ROAD MACKIE HEALTH CENTER - REYNOLDS GYMNASIUM - WINGATE RD
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City | WINSTON SALEM
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State | NC
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Zip | 27106
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Country | US
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Telephone | 336-758-5218
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Fax | 336-758-6054
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Provider Business Mailing Address
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Address Line | PO BOX 7386 WAKE FOREST UNIVERSITY STUDENT HEALTH SERVICE
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City | WINSTON SALEM
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State | NC
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Zip | 27109-7386
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Country | US
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Telephone | 336-758-5218
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Fax | 336-758-6054
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30846
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License Number State | NC
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