O'laf Sorento Massenburg PA-C

NPI 1013114701 - Physician Assistant - 363AM0700X

NPI Details
NPI 1013114701
Gender Male
Enumeration Date 06/27/2007
Last Updated 07/02/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
2337 WINTERHAVEN LANE
WINSTON-SALEM NC, 27103-6792, US
Phone (336) 760-8999
Fax (336) 659-7027
Business Location
1309 LEES CHAPEL ROAD
GREENSBORO NC, 27455-2601, US
Phone (336) 286-5505
Fax (336) 286-5583
Toxanomy
Taxonomy Code 363AM0700X
License State North Carolina
License Number 101117
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According to our database, Mr. O'laf Sorento Massenburg PA-C NPI is 1013114701, taxonomy code is 363AM0700X and license number is 101117, license state is located at North Carolina. O'laf Sorento Massenburg PA-C physically located at 2337 Winterhaven Lane, Winston-salem NC, 27103-6792. NPI Number O'laf Sorento Massenburg PA-C has the Individual type.

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1013114701 NPI number is provided on an as is basis without warranty of any kind. 1013114701 is maintained by the National Plan & Provider Enumeration System. The contents of O'laf Sorento Massenburg PA-C are for informational purposes only.