Organization
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Active
Other names
RAI Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LEIZMAN (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
950 REYNOLDS BLVD, WINSTON SALEM, NC 27105-3450
(336) 741-3228
Mailing address
5500 MARYLAND WAY, STE 200, BRENTWOOD, TN 37027-4948
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
10/13/2022
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