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Organization

BETHANY MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LENIN PETERS M.D. (PRESIDENT/CEO)
(336) 883-0029
Entity
Organization

Contact information

Practice address
3402 BATTLEGROUND AVE, GREENSBORO, NC 27410-2404
(336) 883-0029
(336) 883-0867
Mailing address
507 N LINDSAY ST, HIGH POINT, NC 27262-4303
(336) 883-0029
(336) 883-0867

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
36839
NC
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
2013-01110
NC
207RG0100X
Gastroenterology Physician
101104
NC
207RG0100X
Gastroenterology Physician
103837
NC
207RP1001X
Pulmonary Disease Physician
35265
NC
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1619398997
NC
05
1780015842
NC
05
1992133870
NC
05
2316178
NC
05
3409940
NC
05
5607644
NC
05
7901101
NC
05
89011F1
NC
Enumeration date
01/12/2016
Last updated
10/13/2025
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