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2150 Country Club Rd Ste 300 Winston Salem NC 27104-4241 | |
| (336) 277-5881 | |
| (336) 277-7823 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2150 Country Club Rd Ste 300, Winston Salem, North Carolina |
| Authorized Official Name and Position | Geoffrey K Gardner (VP OF FINANCE) |
| Authorized Official Contact | 7043847840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: () - | 2150 Country Club Rd Ste 300 Winston Salem NC 27104-4241 Ph: (336) 277-5881 |
| NPI Number | 1558877902 |
|---|---|
| Provider Enumeration Date | 12/21/2017 |
| Last Update Date | 03/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558877902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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