# MDFAMILY MEDICAL GROUP

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

## Provider details

- **NPI number:** 1922274240
- **Authorized official:** AUDREY SANDERS (CHIEF OPERATIONS OFFICER)
- **Authorized official phone:** (704) 527-6322

## Contact information

- **Practice address:** 138 S CHERRY ST, WINSTON SALEM, NC 27101-5272
- **Practice address phone:** (704) 527-6322
- **Mailing address:** 4530 PARK RD STE 200, CHARLOTTE, NC 28209-3790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/06/2008
- **Last updated:** 05/06/2008