| |
1750 Kernersville Medical Pkwy Kernersville NC 27284-7146 | |
(336) 564-4866 | |
(336) 277-6815 |
Full Name | |
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Speciality | Hospitalist |
Location | 1750 Kernersville Medical Pkwy, Kernersville, 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 |
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Po Box 60447 Charlotte NC 28260-0447 Ph: (336) 564-4866 | 1750 Kernersville Medical Pkwy Kernersville NC 27284-7146 Ph: (336) 564-4866 |
NPI Number | 1033415377 |
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Provider Enumeration Date | 02/03/2011 |
Last Update Date | 06/20/2024 |
Identifier | Type | State | Issuer |
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1033415377 | NPI | - | NPPES |
5917401 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208M00000X | Hospitalist | (* (Not Available)) | Primary |
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