Peace Haven Internal Medicine | |
1930 North Peace Haven Rd Winston Salem NC 27106-4817 | |
(336) 760-5400 | |
(336) 760-0254 |
Full Name | Peace Haven Internal Medicine |
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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 |
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Peace Haven Internal Medicine 1930 North Peace Haven Rd Winston Salem NC 27106-4817 Ph: (336) 760-5400 | Peace Haven Internal Medicine 1930 North Peace Haven Rd Winston Salem NC 27106-4817 Ph: (336) 760-5400 |
NPI Number | 1073506358 |
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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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