# FORSYTH MEMORIAL HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Lewisville Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902864895
- **Authorized official:** SHALA DAVIS (RCS MGR)
- **Authorized official phone:** (704) 303-7517

## Contact information

- **Practice address:** 1225 LEWISVILLE CLEMMONS RD, LEWISVILLE, NC 27023-8251
- **Practice address phone:** (336) 712-0700
- **Practice address fax:** (336) 712-0876
- **Mailing address:** PO BOX 751803, CHARLOTTE, NC 28275-1803
- **Mailing address phone:** (704) 384-9144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2006
- **Last updated:** 08/18/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 890155W | — | NC |
| 01 | — | CA1315 | RAILROAD MEDICARE | NC |