# FORSYTH CARDIAC & VASCULAR SURGEONS, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902909328
- **Authorized official:** MS. PENNY RODRIGUEZ (AR & CREDENTIALING MANAGER)
- **Authorized official phone:** (336) 794-9616

## Contact information

- **Practice address:** 4622 COUNTRY CLUB RD, SUITE 180, WINSTON SALEM, NC 27104-3770
- **Practice address phone:** (336) 768-9535
- **Practice address fax:** (336) 768-4155
- **Mailing address:** 4622 COUNTRY CLUB RD, SUITE 180, WINSTON-SALEM, NC 27104-3770
- **Mailing address phone:** (336) 768-9535
- **Mailing address fax:** (336) 768-4155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 40490 | NC | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 10/27/2010