| Jaime E Trujillo MD PA | |
|
3080 Trenwest Drive Winston Salem NC 27103 | |
| (336) 768-0496 | |
| (336) 768-0498 |
| Full Name | Jaime E Trujillo MD PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 3080 Trenwest Drive, Winston Salem, North Carolina |
| Authorized Official Name and Position | Jaime E Trujill0 (PRESIDENT) |
| Authorized Official Contact | 3367680496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaime E Trujillo MD PA 3080 Trenwest Drive Winston Salem NC 27103 Ph: (336) 768-0496 | Jaime E Trujillo MD PA 3080 Trenwest Drive Winston Salem NC 27103 Ph: (336) 768-0496 |
| NPI Number | 1730301037 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 11/30/2018 |
| Medicare PECOS PAC ID | 3072416049 |
|---|---|
| Medicare Enrollment ID | O20040128000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730301037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | () | Secondary |
| Provider Name | Jaime E Trujillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073564399 PECOS PAC ID: 4587567557 Enrollment ID: I20100806000039 |
| Provider Name | Elvy Pettit |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972775427 PECOS PAC ID: 1850585100 Enrollment ID: I20101030000179 |
| Provider Name | Roumyana Ivanova Spassova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588914337 PECOS PAC ID: 7517283476 Enrollment ID: I20150312000046 |
| Provider Name | Liliana Pitu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942779475 PECOS PAC ID: 3274873450 Enrollment ID: I20190326001614 |
| Provider Name | Selby Gage Rouch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376005942 PECOS PAC ID: 5991033664 Enrollment ID: I20190820002811 |
| Provider Name | Latara Craddock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942821152 PECOS PAC ID: 1951721653 Enrollment ID: I20201019002485 |
| Provider Name | Stacey Jefferson Coats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548934847 PECOS PAC ID: 0941605729 Enrollment ID: I20210817000979 |
| Provider Name | Hannah Clark St. Jeor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023598059 PECOS PAC ID: 4486905627 Enrollment ID: I20220608003277 |
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