Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Other names
Novant Health Salem Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
105 VEST MILL CIR, WINSTON SALEM, NC 27103-2943
(336) 718-7800
(336) 718-7900
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-7800
(336) 718-7900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890258W
—
NC
01
—
CA1315
RAILROAD MEDICARE
NC
Enumeration date
05/04/2006
Last updated
07/12/2023
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