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861 Old Winston Rd Suite 101 Kernersville NC 27284-7140 | |
(336) 904-0043 | |
(336) 904-0046 |
Full Name | |
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Speciality | Internal Medicine |
Location | 861 Old Winston Rd, Kernersville, 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 |
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100 Kimel Forest Dr Winston Salem NC 27103-6074 Ph: (336) 716-1331 | 861 Old Winston Rd Suite 101 Kernersville NC 27284-7140 Ph: (336) 904-0043 |
NPI Number | 1922434307 |
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Provider Enumeration Date | 09/18/2013 |
Last Update Date | 11/29/2023 |
Identifier | Type | State | Issuer |
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1922434307 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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