LEONORA CULP BOMAR (NPI# 1861842031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861842031 |
| Entity Type | Individual |
| Full Name | LEONORA CULP BOMAR |
| Credential | MD |
| Practice Address |
4618 Country Club Rd Winston Salem NC 27104-3520 |
| Practice Telephone | 3367163926 |
| Mailing Telephone | 3367163926 |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 228041 | NC | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | LL39812 | SC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 701 Grove Rd, Greenville, SC 296054210 | 8644557882 | 8644557882 |
| Street Address |
4618 COUNTRY CLUB RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104-3520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720063175 | Steven Richard Feldman | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-08 |
| 1487213047 | Diana Isabel Munoz Ali | Nurse Practitioner | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2019-06-07 |
| 1629544689 | Kimberly Kincaid Mcpeeks | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2018-10-17 |
| 1912392903 | Melissa Brooke Hoffman | Student in an Organized Health Care Education/Training Program | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2015-04-06 |
| 1083031090 | Jessica Alexis Savas | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2014-03-27 |
| 1164779997 | Amber Brewer Keller | Physician Assistant | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2012-08-10 |
| 1629272455 | William Wei-ting Huang | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2007-06-14 |
| 1841228335 | Adele Clark | Physician Assistant | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2006-06-30 |
| 1316923360 | Joseph Lucius Jorizzo | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-21 |
| 1518943943 | Phillip Mabon Williford | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| Find all providers in zip 27104 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982067120 | Jacquelyn Marjorie Majerowski | Dermatology | Department of Pathology Medical Center Boulevard, Winston Salem, NC 27157-4330 | 2016-04-04 |
| 1588077747 | Christine Ahn | Dermatology | 300 Medical Center Blvd, Winston Salem, NC 27157-0003 | 2014-06-05 |
| 1437379476 | Wesley Raymond Hawfield | Dermatology | 175 Kimel Park Drive, Winston Salem, NC 27103-1508 | 2007-05-01 |
| 1164573226 | Sarah L Taylor | Dermatology | 4618 Country Club Road, Wake Forest Baptist Health Medical Plaza, Winston Salem, NC 27104-3520 | 2007-01-16 |
| 1699836908 | Triad Dermatology Pa | Dermatology | 725 Highland Oaks Drive, Suite 106, Winston Salem, NC 27103 | 2006-12-12 |
| 1578675179 | Anne L White | Dermatology | 1255 Creekshire Way Ste 290, Winston Salem, NC 27103-3061 | 2006-08-31 |
| 1649237082 | Skin Surgery Center Pa | Dermatology | 1450 Professional Park Dr, Suite 150, Winston Salem, NC 27103-1300 | 2006-04-28 |
| 1720063175 | Steven Richard Feldman | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-08 |
| 1497756647 | Alan D Klein | Dermatology | 2020 Peace Haven Rd, Winston Salem, NC 27106-4851 | 2005-08-09 |
| 1932108461 | Paul Douglass Wortman | Dermatology | 127 S Poplar St, Winston Salem, NC 27101-3755 | 2005-07-18 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.