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NPI Code Detail

MEDICARE: WAKE FOREST HEALTH NETWORK LLC

MEDICARE: WAKE FOREST HEALTH NETWORK LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1477828788
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAKE FOREST HEALTH NETWORK LLC
Provider Business Mailing Address
First Line : 2359 SPRINGS RD NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-3067
Country : US
Telephone Number : 828-256-9853
Fax Number : 828-256-1255
Provider Business Practice Location Address
First Line : 2359 SPRINGS RD NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-3067
Country : US
Telephone Number : 828-256-9853
Fax Number : 828-256-1255
Authorized Official
Title or Position : SR VP CLINICAL OPERATIONS
Name : CRAIG MICHAEL GREVEN
Credential : MD
Telephone Number : 336-716-1331
Provider Enumeration Date : 03/20/2012
Last Update Date : 09/25/2025

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Directions to “WAKE FOREST HEALTH NETWORK LLC ” Practice Location

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