Provider Demographics
NPI:1659651792
Name:WINSTEAD, MARSHA B
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:B
Last Name:WINSTEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 DOW RD
Mailing Address - Street 2:
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-4514
Mailing Address - Country:US
Mailing Address - Phone:910-458-3060
Mailing Address - Fax:910-458-2785
Practice Address - Street 1:901 DOW RD
Practice Address - Street 2:
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-4514
Practice Address - Country:US
Practice Address - Phone:910-458-3060
Practice Address - Fax:910-458-2785
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-21
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist