| Novant Health Child & Adolescent Psychiatric Medicine | |
|
140 Kimel Park Dr Ste 101 Winston Salem NC 27103-6185 | |
| (336) 718-7280 | |
| (336) 718-7290 |
| Full Name | Novant Health Child & Adolescent Psychiatric Medicine |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 140 Kimel Park Dr Ste 101, Winston Salem, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Health Child & Adolescent Psychiatric Medicine Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 316-7585 | Novant Health Child & Adolescent Psychiatric Medicine 140 Kimel Park Dr Ste 101 Winston Salem NC 27103-6185 Ph: (336) 718-7280 |
| NPI Number | 1588191563 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588191563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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