Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Other names
Novant Health Urology
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
2010 BALDWIN LANE, WINSTON SALEM, NC 27103
(336) 277-1717
(336) 277-1718
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-1717
(337) 277-1718
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909023
—
NC
Enumeration date
06/11/2007
Last updated
07/12/2023
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