Provider Demographics
NPI:1356435804
Name:DURHAM, CYNTHIA SUTTON (DC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SUTTON
Last Name:DURHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 N SILAS CREEK PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106
Mailing Address - Country:US
Mailing Address - Phone:336-765-7620
Mailing Address - Fax:336-765-3801
Practice Address - Street 1:5201 N SILAS CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106
Practice Address - Country:US
Practice Address - Phone:336-765-7620
Practice Address - Fax:336-765-3801
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890839TMedicaid
NC5177056OtherAETNA
NC0839TOtherBCBSNC
NC33110OtherPARTNERS
NC607887OtherACN
NC607887OtherACN
NC5177056OtherAETNA