Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Other names
Novant Health Forsyth Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6087
Entity
Organization
Contact information
Practice address
1381 WESTGATE CENTER DR, WINSTON-SALEM, NC 27103-2934
(336) 718-0100
(336) 718-0120
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(704) 384-7606
(336) 277-7722
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01531
BCBD ID#
NC
01
—
2330
PARTNERS ID#
NC
01
—
5425016
AETNA ID#
NC
05
—
6901531
—
NC
01
—
CA1315
RAILROAD MCR ID#
NC
Enumeration date
05/04/2006
Last updated
07/10/2023
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