Organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Active
Parent organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Other names
Northwest Digestive Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Authorized official
MR. LEWIS S. THORP III (PRESIDENT CEO)
(336) 721-3900
Entity
Organization
Contact information
Practice address
1916 W PARK DR, NORTH WILKESBORO, NC 28659-3563
(336) 903-2900
(336) 903-2908
Mailing address
1916 WEST PARK DRIVE, NORTH WILKESBORO, NC 28659
(336) 721-3900
(336) 903-2908
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2317728V
MEDICARE GROUP NUMBER
NC
05
—
5906867
—
NC
Enumeration date
05/10/2007
Last updated
04/10/2008
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