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Organization

NORTH CAROLINA BAPTIST HOSPITAL

Active
Parent organization
NORTH CAROLINA BAPTIST HOSPITAL
Other names
Winston East Pediatrics
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTH CAROLINA BAPTIST HOSPITAL
Authorized official
MR. DONNY C LAMBETH (PRESIDENT)
(336) 716-3003
Entity
Organization

Contact information

Practice address
2295 E 14TH ST, SUITE 100, WINSTON SALEM, NC 27105-6804
(336) 715-0514
(336) 725-2173
Mailing address
PO BOX 751730, CHARLOTTE, NC 28275-1730
(336) 716-3539
(336) 716-5888

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
H0011
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2333292B
MEDICARE PART B
NC
05
3400047
NC
01
H0011
STATE LICENSE
NC
Enumeration date
03/26/2008
Last updated
10/01/2009
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