Michael Glock, MD | |
Medical Center Blvd, Winston Salem, NC 27157-0001 | |
(336) 716-2255 | |
Not Available |
Full Name | Michael Glock |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Gastroenterology |
Location | Medical Center Blvd, Winston Salem, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033194006 | NPI | - | NPPES |
2794 | Other | PARTNERS | |
44931 | Other | MEDCOST | |
215713000 | Medicaid | WV | |
8935991 | Medicaid | NC | |
35991 | Other | BCBS | |
6710026 | Medicaid | VA | |
4525084 | Other | AETNA | |
Q35903 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0206X | Pediatrics - Pediatric Gastroenterology | 35903 (North Carolina) | Primary |
Entity Name | Wake Forest University Health Sciences |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
Mailing Address | Practice Location Address |
---|---|
Michael Glock, MD Po Box 344, Winston Salem, NC 27102-0344 Ph: (336) 716-2255 | Michael Glock, MD Medical Center Blvd, Winston Salem, NC 27157-0001 Ph: (336) 716-2255 |
Niyati Mahajan, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2295 E 14th St, Winston Salem, NC 27105 Phone: 336-713-8860 Fax: 336-713-8862 | |
Dr. Soren Morgan Johnson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1350 Whitaker Ridge Dr, Winston Salem, NC 27106 Phone: 336-718-8000 Fax: 336-718-8011 | |
Jane Meschan Foy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 | |
Modupeola O Akinola, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 | |
David Scott Anderson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1350 Whitaker Ridge Dr, Winston Salem, NC 27106 Phone: 336-718-8000 Fax: 336-718-8011 | |
Dr. Veronica Nicola Wiltshire, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3333 Brookview Hills Blvd Ste 201, Winston Salem, NC 27103 Phone: 336-713-8660 Fax: 336-702-9276 | |
Mrs. Julie Renee Kerth, CPNP-AC Pediatrics Medicare: Medicare Enrolled Practice Location: Wake Forest Baptist Medical Center 1, Winston Salem, NC 27157 Phone: 336-713-4500 |