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General NPI Number Information
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NPI Number | 1619398997
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Entity Type | Organization
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Legal Business Name | BETHANY MEDICAL CENTER
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 495 ARBOR HILL RD STE M
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City | KERNERSVILLE
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State | NC
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Zip | 27284-3335
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Country | US
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Telephone | 336-883-0029
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Fax |
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Provider Business Mailing Address
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Address Line | 507 N LINDSAY ST
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City | HIGH POINT
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State | NC
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Zip | 27262-4303
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Country | US
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Telephone | 336-883-0029
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Fax | 336-899-2188
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LENIN J PETERS
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Credential | M.D.
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Telephone | 336-883-0029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | NC
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