Provider Demographics
NPI:1255311254
Name:DURHAM, MARGARET DONNELL (PA)
Entity Type:Individual
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First Name:MARGARET
Middle Name:DONNELL
Last Name:DURHAM
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Gender:F
Credentials:PA
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Mailing Address - Street 1:2000 FRONTIS PLAZA BLVD STE 200
Mailing Address - Street 2:(ATTN) FORSYTH MEDICAL GROUP
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5616
Mailing Address - Country:US
Mailing Address - Phone:336-277-2435
Mailing Address - Fax:336-277-9275
Practice Address - Street 1:100 ROBINHOOD MEDICAL PLZ
Practice Address - Street 2:DBA MAPLEWOOD FAMILY PRACTICE
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5472
Practice Address - Country:US
Practice Address - Phone:336-718-0800
Practice Address - Fax:336-718-0871
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC01202363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2799344AMedicare ID - Type Unspecified
NCS69321Medicare UPIN