| |
1730 Kernersville Medical Parkway Suite 105 Kernersville NC 27284-7198 | |
(336) 718-0440 | |
(336) 718-0441 |
Full Name | |
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Speciality | Internal Medicine - Infectious Disease |
Location | 1730 Kernersville Medical Parkway, Kernersville, North Carolina |
Authorized Official Name and Position | Leea Jeanine Walton (EDI MANAGER) |
Authorized Official Contact | 7043166081 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 336-7180 | 1730 Kernersville Medical Parkway Suite 105 Kernersville NC 27284-7198 Ph: (336) 718-0440 |
NPI Number | 1982128963 |
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Provider Enumeration Date | 08/01/2017 |
Last Update Date | 06/20/2024 |
Identifier | Type | State | Issuer |
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1982128963 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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