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General NPI Number Information
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NPI Number | 1235474701
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Entity Type | Organization
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Legal Business Name | CORNERSTONE HEALTH CARE
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 1400 WESTGATE CENTER DR SUITE 140
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3112
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Country | US
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Telephone | 336-802-2536
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Fax | 336-802-2534
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Provider Business Mailing Address
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Address Line | 1701 WESTCHESTER DR SUITE 850
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City | HIGH POINT
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State | NC
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Zip | 27262-7008
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Country | US
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Telephone | 336-802-2536
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Fax | 336-802-2534
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | GRACE E TERRELL
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Credential | M.D
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Telephone | 336-802-2536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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