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General NPI Number Information
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NPI Number | 1710453550
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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 | 10/19/2018
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 5093 UNIVERSITY PKWY
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City | WINSTON SALEM
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State | NC
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Zip | 27106-6085
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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 |
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Authorized Official
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Title or Position | CEO
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Name | LENIN J PETERS
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Credential |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #8
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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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