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1225 Lewisville Clemmons Rd Lewisville NC 27023-8251 | |
(336) 712-0700 | |
(336) 712-0876 |
Full Name | |
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Speciality | Family Medicine |
Location | 1225 Lewisville Clemmons Rd, Lewisville, North Carolina |
Authorized Official Name and Position | Shala Davis (RCS MGR) |
Authorized Official Contact | 7043037517 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 751803 Charlotte NC 28275-1803 Ph: (704) 384-9144 | 1225 Lewisville Clemmons Rd Lewisville NC 27023-8251 Ph: (336) 712-0700 |
NPI Number | 1902864895 |
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Provider Enumeration Date | 05/02/2006 |
Last Update Date | 08/18/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902864895 | NPI | - | NPPES |
890155W | Medicaid | NC | |
CA1315 | Other | NC | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Wake Forest Baptist Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6630 Shallowford Rd, Lewisville, NC 27023 Phone: 336-716-9253 | |