Ross Thomas Mangin, PA
Physician Assistant in Winston Salem, NC. Individual provider (NPI-1).
NPI number1982804548
StatusActive
Last updated in NPPESDec 17, 2021
Details
- NPI
- 1982804548
- Entity type
- Individual (NPI-1)
- Name
- Ross Thomas Mangin
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 23, 2007
- Certification date
- Oct 29, 2020
- Last updated
- Dec 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-00979 | NC | Yes |
Practice location
3333 Silas Creek PkwyWinston Salem, NC 27103-3013
Phone 800-899-5757 · Fax 314-821-1833
Mailing address
Po Box 75332Charlotte, NC 28275-0332
Phone 314-238-5260 · Fax 314-821-1833
Other practice locations
1200 N Elm St
Greensboro, NC 27401-1004
Greensboro, NC 27401-1004
Phone 336-716-2255
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