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Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Other names
Novant Health Salem Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
105 VEST MILL CIR, WINSTON SALEM, NC 27103-2943
(336) 718-7800
(336) 718-7900
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-7800
(336) 718-7900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890258W
—
NC
01
—
CA1315
RAILROAD MEDICARE
NC
Enumeration date
05/04/2006
Last updated
07/12/2023
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