Organization
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Active
Parent organization
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Other names
Coliseum Eye Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Authorized official
WILLIAM APPLEGATE MD (INTERIM PRES, WFU HEALTH SCIENCES)
(336) 716-4424
Entity
Organization
Contact information
Practice address
631 COLISEUM DR, WINSTON SALEM, NC 27106-5310
(336) 723-1041
Mailing address
631 COLISEUM DR, WINSTON SALEM, NC 27106-5310
(336) 723-1041
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902646
—
NC
Enumeration date
04/03/2007
Last updated
03/05/2008
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