Organization
WAKE FOREST HEALTH NETWORK LLC
Active
Parent organization
WAKE FOREST HEALTH NETWORK LLC
Other names
Atrium Health Wake Forest Baptist Neurology - Triad
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE FOREST HEALTH NETWORK LLC
Authorized official
CRAIG MICHAEL GREVEN MD (SR VP CLINICAL OPERATIONS)
(336) 716-1331
Entity
Organization
Contact information
Practice address
145 KIMEL PARK DR, SUITE 100, WINSTON SALEM, NC 27103-6983
(336) 768-6347
(336) 760-9393
Mailing address
145 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103-6983
(336) 768-6347
(336) 760-9393
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016UW
BCBS
NC
01
—
269374
MAMSI
—
05
—
89016UW
—
NC
01
—
B0433
MEDCOST
—
01
—
CB8658
RRMC
NC
01
—
CC4241
RRMC
NC
01
—
CC4242
RR MEDICARE
NC
01
—
CC4243
RR MEDICARE
NC
01
—
CC5472
RR MEDICARE
NC
01
—
CC6608
RR MEDICARE
NC
01
—
CD6614
RR MEDICARE
NC
01
—
CF9200
RR MEDICARE
NC
01
—
D266
PARTNERS MEDICARE CHOICE
NC
Enumeration date
03/12/2007
Last updated
09/25/2025
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