MEDICARE: BETHANY MEDICAL CENTER

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
1	208VP0000X	Pain Medicine Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1528554631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHANY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	507 N LINDSAY ST
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-4303
Country	:	US
Telephone Number	:	336-883-0029
Fax Number	:	336-899-2176

Provider Business Practice Location Address
First Line	:	160 KIMEL FOREST DR STE 100
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6084
Country	:	US
Telephone Number	:	336-883-0029
Fax Number	:	336-899-2176

Authorized Official
Title or Position	:	CEO
Name	:	LENIN J PETERS
Credential	:	MD
Telephone Number	:	336-883-0029

Provider Enumeration Date	:	07/02/2018
Last Update Date	:	10/13/2025

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Directions to “BETHANY MEDICAL CENTER ” Practice Location

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