Provider Demographics
NPI:1235536798
Name:WILLIAM BYNUM
Entity Type:Organization
Organization Name:WILLIAM BYNUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:336-450-8537
Mailing Address - Street 1:1025 E WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6775
Mailing Address - Country:US
Mailing Address - Phone:919-260-0955
Mailing Address - Fax:336-474-2438
Practice Address - Street 1:1025 E WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6775
Practice Address - Country:US
Practice Address - Phone:919-260-0955
Practice Address - Fax:336-474-2438
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR HEALING AND WELLNESS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC74045251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1497175244Medicare NSC