| Atrium Health Wake Forest Baptist Behavioral Medicine - Fslr Pediatric | |
|
2933 Maplewood Ave Ste 1 Winston Salem NC 27103-4001 | |
| (336) 802-2205 | |
| (336) 802-2206 |
| Full Name | Atrium Health Wake Forest Baptist Behavioral Medicine - Fslr Pediatric |
|---|---|
| Speciality | Psychologist |
| Location | 2933 Maplewood Ave Ste 1, Winston Salem, North Carolina |
| Authorized Official Name and Position | Russell Mars Howerton (SR VP NETWORK PHYS & HS CMO) |
| Authorized Official Contact | 3367161331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atrium Health Wake Forest Baptist Behavioral Medicine - Fslr Pediatric 100 Kimel Forest Dr Winston Salem NC 27103-6074 Ph: (336) 716-1331 | Atrium Health Wake Forest Baptist Behavioral Medicine - Fslr Pediatric 2933 Maplewood Ave Ste 1 Winston Salem NC 27103-4001 Ph: (336) 802-2205 |
| NPI Number | 1538504238 |
|---|---|
| Provider Enumeration Date | 05/08/2013 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538504238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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