Organization
WAKE FOREST HEALTH NETWORK, LLC
Active
Other names
Atrium Health Wake Forest Baptist Shapiro Eye Care - Greensboro
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL MARS HOWERTON (SR VP NETWORK PHYS & HS CMO)
(336) 716-1331
Entity
Organization
Contact information
Practice address
1311 N ELM ST STE A, GREENSBORO, NC 27401-6306
(336) 378-9993
(336) 274-5884
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5917544
—
NC
Enumeration date
03/02/2011
Last updated
02/05/2024
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