Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sidney Wilson Lavender II, PAC

Individual provider Surgical Physician Assistant · NPI 1609859313

Sidney Wilson Lavender II, PAC is a Surgical Physician Assistant in Winston Salem, North Carolina. Licensed in North Carolina. Registered with an NPI since 2005.

Licensed in
NC
In the registry since
2005
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Partly verified

Some contact details are missing from the federal record.

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone: (336) 716-2255
Fax: (336) 716-3348
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 000100189 (NC)

Record details

NPI number1609859313
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedNovember 28, 2005
Last updated in NPPESAugust 20, 2010

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