Healthcare Provider Details

I. General information

NPI: 1023938271
Provider Name (Legal Business Name): CORNERSTONE CLINICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 S STRATFORD RD STE 400
WINSTON SALEM NC
27103-1867
US

IV. Provider business mailing address

514 S STRATFORD RD STE 400
WINSTON SALEM NC
27103-1867
US

V. Phone/Fax

Practice location:
  • Phone: 212-734-6621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SIMON FENSTERSZAUB
Title or Position: DO
Credential:
Phone: 212-734-6621