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Organization
WAKE FOREST HEALTH NETWORK LLC
Active
Organization
WAKE FOREST HEALTH NETWORK LLC
Active
Other names
Atrium Health Wake Forest Baptist Family Medicine - Archdale
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG MICHAEL GREVEN MD (SR VP CLINICAL OPERATIONS)
(336) 716-1331
Entity
Organization
Contact information
Practice address
10188 N MAIN ST, ARCHDALE, NC 27263-2906
(336) 802-2070
(336) 802-2071
Mailing address
10188 N MAIN ST, ARCHDALE, NC 27263-2906
(336) 802-2070
(336) 802-2071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0247K
BCBS
NC
01
—
1212660021
DME
NC
01
—
25220
MEDCOST
NC
05
—
5908889
—
NC
01
—
7584779
AETNA
NC
05
—
890247K
—
NC
01
—
CB8658
RR MEDICARE
NC
01
—
CC4241
RR MEDICARE
NC
01
—
CC4243
RR MEDICARE
NC
01
—
CD6614
RR MEDICARE
NC
01
—
D266
PARTNERS
NC
Enumeration date
03/19/2007
Last updated
09/25/2025
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