Provider Demographics
NPI:1891321337
Name:AYRES, PHILIPPE FREIRE
Entity Type:Individual
Prefix:
First Name:PHILIPPE
Middle Name:FREIRE
Last Name:AYRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 VINE ST.
Mailing Address - Street 2:BOWMAN GRAY CENTER FOR MEDICAL EDUCATION
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101
Mailing Address - Country:US
Mailing Address - Phone:443-538-6258
Mailing Address - Fax:
Practice Address - Street 1:475 VINE ST.
Practice Address - Street 2:BOWMAN GRAY CENTER FOR MEDICAL EDUCATION
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101
Practice Address - Country:US
Practice Address - Phone:336-716-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant