# CEDAR CREEK FAMILY MEDICINE PLLC

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

## Provider details

- **NPI number:** 1952579807
- **Authorized official:** KIMBERLY R NIFONG MD (CO OWNER)
- **Authorized official phone:** (336) 784-0505

## Contact information

- **Practice address:** 11492 OLD US HIGHWAY 52, WINSTON SALEM, NC 27107-9497
- **Practice address phone:** (336) 784-0505
- **Practice address fax:** (336) 784-0531
- **Mailing address:** 5350 S MAIN ST, WINSTON SALEM, NC 27107-9174
- **Mailing address phone:** (336) 784-0505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 88463 | NC | Yes |

## Other

- **Enumeration date:** 02/13/2008
- **Last updated:** 09/10/2024