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2415 S Stratford Rd Winston Salem NC 27103-6225 | |
(336) 741-1319 | |
(336) 218-6787 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 2415 S Stratford Rd, Winston Salem, North Carolina |
Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Suite 400 Brentwood TN 37027-7048 Ph: () - | 2415 S Stratford Rd Winston Salem NC 27103-6225 Ph: (336) 741-1319 |
NPI Number | 1093267411 |
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Provider Enumeration Date | 11/02/2016 |
Last Update Date | 10/13/2022 |
Identifier | Type | State | Issuer |
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1093267411 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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