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1930 North Peace Haven Rd Winston Salem NC 27106-4817 | |
| (336) 760-5400 | |
| (336) 760-0254 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1930 North Peace Haven Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Lewis S Thorp (PRESIDENT CEO) |
| Authorized Official Contact | 3367213900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1930 North Peace Haven Rd Winston Salem NC 27106-4817 Ph: (336) 760-5400 | 1930 North Peace Haven Rd Winston Salem NC 27106-4817 Ph: (336) 760-5400 |
| NPI Number | 1073506358 |
|---|---|
| Provider Enumeration Date | 08/23/2005 |
| Last Update Date | 04/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073506358 | NPI | - | NPPES |
| 890237T | Medicaid | NC | |
| 2317728F | Other | NC | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (North Carolina) | Primary |
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