# WAKE FOREST HEALTH NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pinewest OB-Gyn at Premier
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659718922
- **Authorized official:** RUSSELL MARS HOWERTON MD (SR VP NETWORK PHYS & HS CMO)
- **Authorized official phone:** (336) 716-1331

## Contact information

- **Practice address:** 4515 PREMIER DR, SUITE 405, HIGH POINT, NC 27265-8357
- **Practice address phone:** (336) 885-0149
- **Practice address fax:** (336) 885-2933
- **Mailing address:** 100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
- **Mailing address phone:** (336) 716-1331
- **Mailing address fax:** (336) 716-3202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/28/2013
- **Last updated:** 09/02/2021