Provider Demographics
NPI:1164480927
Name:ALBERTINI, JOHN G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:ALBERTINI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1450 PROFESSIONAL PARK DR
Mailing Address - Street 2:STE 150
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1300
Mailing Address - Country:US
Mailing Address - Phone:336-724-2434
Mailing Address - Fax:336-724-6123
Practice Address - Street 1:1450 PROFESSIONAL PARK DR
Practice Address - Street 2:STE 150
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1300
Practice Address - Country:US
Practice Address - Phone:336-724-2434
Practice Address - Fax:336-724-6123
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2002-00194207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89131X5Medicaid
NC2002660Medicare ID - Type Unspecified
NC89131X5Medicaid