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1710 Kernersville Medical Pkwy Ste 210 Kernersville NC 27284-7157 | |
(336) 718-6770 | |
(336) 277-1889 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1710 Kernersville Medical Pkwy Ste 210, Kernersville, North Carolina |
Authorized Official Name and Position | Shala Davis (MANAGED CARE MANAGER) |
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 60447 Charlotte NC 28260-0447 Ph: () - | 1710 Kernersville Medical Pkwy Ste 210 Kernersville NC 27284-7157 Ph: (336) 718-6770 |
NPI Number | 1306482922 |
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Provider Enumeration Date | 11/19/2019 |
Last Update Date | 08/17/2021 |
Identifier | Type | State | Issuer |
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1306482922 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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