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Organization

FORSYTH MEMORIAL HOSPITAL INC

Active
Other names
Pilot Mountain Family Practice
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELE GRIER (VP OPERATIONS)
(336) 368-5011
Entity
Organization

Contact information

Practice address
207 MEDICAL STREET, DBA PILOT MOUNTAIN FAMILY PRACTICE, PILOT MOUNTAIN, NC 27041-8656
(336) 368-5011
(336) 368-1424
Mailing address
2000 FRONTIS PLAZA BLVD STE 102, (ATTN) FORSYTH MEDICAL GROUP, WINSTON SALEM, NC 27103-5616
(336) 368-5011
(336) 368-1424

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890239J
NC
Enumeration date
03/26/2007
Last updated
08/14/2008
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