Provider Demographics
NPI:1114986403
Name:PERAL, LINDAY S (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDAY
Middle Name:S
Last Name:PERAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1834 WAKE FOREST RD
Mailing Address - Street 2:GEORGE C MACKIE HEALTH CENTER
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27109-6000
Mailing Address - Country:US
Mailing Address - Phone:336-758-5218
Mailing Address - Fax:336-758-6054
Practice Address - Street 1:1834 WAKE FOREST RD
Practice Address - Street 2:GEORGE C MACKIE HEALTH CENTER
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27109-6000
Practice Address - Country:US
Practice Address - Phone:336-758-5218
Practice Address - Fax:336-758-6054
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200301158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89137UYMedicaid
BP8654659OtherFEDERAL DEA
BP8654659OtherFEDERAL DEA
I16720Medicare UPIN