Organization
WAKE FOREST BAPTIST IMAGING LLC
Active
Other names
Atrium Health Wake Forest Baptist Imaging Friendly - Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
AMY STOUT (PRESIDENT/CEO)
(615) 261-2306
Entity
Organization
Contact information
Practice address
3120 NORTHLINE AVE STE 3120-101, GREENSBORO, NC 27408-7814
(336) 765-5722
(336) 765-5723
Mailing address
PO BOX 1000 DEPT 842, MEMPHIS, TN 38148-0842
(615) 261-2306
(855) 588-3545
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
05/13/2024
Last updated
10/21/2024
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