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Organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Active
Organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Active
Parent organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Other names
Newsome Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Authorized official
MR. LEWIS S THORP III (PRESIDENT/CEO)
(336) 721-3900
Entity
Organization
Contact information
Practice address
304 MOUNTAIN VIEW RD, KING, NC 27021-8768
(336) 983-6898
(336) 983-6921
Mailing address
304 MOUNTAINVIEW ROAD, KING, NC 27021-2468
(336) 983-6898
(336) 983-6921
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2317728U
MEDICARE GROUP NUMBER
NC
05
—
5905989
—
NC
Enumeration date
08/24/2005
Last updated
04/10/2008
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