Provider Demographics
NPI:1003890492
Name:WINSLOW, JAMES ELBERT III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ELBERT
Last Name:WINSLOW
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27102-0344
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-5438
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:336-716-5438
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100108207P00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
7837341OtherAETNA
13012OtherBCBS
VA9999914Medicaid
C6009OtherMEDCOST
WV2005269000Medicaid
NC8913012Medicaid
800681OtherPARTNERS
P00009557OtherRR MEDICARE
SCQ00108Medicaid
NC8913012Medicaid
NC2000075BMedicare ID - Type Unspecified