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General NPI Number Information
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NPI Number | 1376117176
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Entity Type | Organization
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Legal Business Name | WAKE FOREST UNIVERSITY HEALTH SCIENCES
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 486 N PATTERSON AVE FL 5
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City | WINSTON SALEM
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State | NC
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Zip | 27101-4261
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Country | US
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Telephone | 336-713-3868
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Fax | 336-716-4941
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Provider Business Mailing Address
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Address Line | 486 N PATTERSON AVE FL 5
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City | WINSTON SALEM
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State | NC
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Zip | 27101-4261
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Country | US
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Telephone | 336-713-3868
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Fax | 336-716-4941
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Authorized Official
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Title or Position | BUSINESS MANAGER, BESTHEALTH FOR BU
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Name | GABRIELLE BELSER
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Credential |
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Telephone | 336-716-3379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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