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50 Miller St Ste G Winston Salem NC 27104 | |
| (704) 384-7605 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 50 Miller St, Winston Salem, North Carolina |
| Authorized Official Name and Position | Geoffrey K Gardner (VP OF FINANCE) |
| Authorized Official Contact | 7043847605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | 50 Miller St Ste G Winston Salem NC 27104 Ph: (704) 384-7605 |
| NPI Number | 1639620107 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 08/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639620107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (North Carolina) | Primary |
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