Provider Demographics
NPI:1053351965
Name:BATES, DWIGHT D (MD)
Entity type:Individual
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First Name:DWIGHT
Middle Name:D
Last Name:BATES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7008
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1132 N CHURCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1039
Practice Address - Country:US
Practice Address - Phone:336-379-9445
Practice Address - Fax:336-691-1704
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-02-14
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Provider Licenses
StateLicense IDTaxonomies
NC200500157207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904651Medicaid
NC5904651Medicaid