Organization
FORSYTH MEMORIAL HOSPITAL, INC
Active
Other names
Novant Health Surry Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
865 WESTLAKE DR, MOUNT AIRY, NC 27030-2102
(336) 719-6100
(336) 719-2313
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 719-6100
(336) 719-2313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890209K
—
NC
01
—
CA1315
RAILROAD MEDICARE
NC
Enumeration date
05/04/2006
Last updated
06/04/2024
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