| Novant Health Psychiatric Medicine | |
|
175 Kimel Park Dr Suite 100 Winston Salem NC 27103-6951 | |
| (336) 277-1800 | |
| (336) 277-9538 |
| Full Name | Novant Health Psychiatric Medicine |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 175 Kimel Park Dr, Winston Salem, North Carolina |
| Authorized Official Name and Position | Geoffrey K Gardner (VP OF FINANCE) |
| Authorized Official Contact | 7043849094 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Health Psychiatric Medicine Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | Novant Health Psychiatric Medicine 175 Kimel Park Dr Suite 100 Winston Salem NC 27103-6951 Ph: (336) 277-1800 |
| NPI Number | 1043503287 |
|---|---|
| Provider Enumeration Date | 05/20/2011 |
| Last Update Date | 06/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043503287 | NPI | - | NPPES |
| 5917753 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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