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Organization
FORSYTH CARDIAC & VASCULAR SURGEONS, P.A.
Active
Organization
FORSYTH CARDIAC & VASCULAR SURGEONS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PENNY RODRIGUEZ (AR & CREDENTIALING MANAGER)
(336) 794-9616
Entity
Organization
Contact information
Practice address
4622 COUNTRY CLUB RD, SUITE 180, WINSTON SALEM, NC 27104-3770
(336) 768-9535
(336) 768-4155
Mailing address
4622 COUNTRY CLUB RD, SUITE 180, WINSTON-SALEM, NC 27104-3770
(336) 768-9535
(336) 768-4155
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
40490
NC
Other
Enumeration date
09/07/2006
Last updated
10/27/2010
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