Individual ProviderRupesh ManamInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address186 Kimel Park Dr, Winston Salem, NC 27103-6946(336) 277-2000PECOS EnrollmentBased on the most recent information from CMS, provider Rupesh Manam is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1184079519Provider TypeIndividualFull NameManam, RupeshTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/4/2016Last Updated7/29/2022Contact InformationPractice LocationPractice Address186 Kimel Park Dr, Winston Salem, NC 27103-6946Phone(336) 277-2000Fax(336) 277-2050Mailing LocationMailing AddressPO Box 751803, Charlotte, NC 28275-1803Phone(336) 277-2000Fax(336) 277-2050Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense2020-04235North CarolinaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerFlorida