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General NPI Number Information
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NPI Number | 1790809531
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Entity Type | Organization
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Legal Business Name | WAKE FOREST HEALTH NETWORK LLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1814 WESTCHESTER DR SUITE 401
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City | HIGH POINT
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State | NC
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Zip | 27262-7299
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Country | US
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Telephone | 336-802-2080
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Fax | 336-802-2081
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Provider Business Mailing Address
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Address Line | 1814 WESTCHESTER DR STE 401
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City | HIGH POINT
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State | NC
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Zip | 27262-7369
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Country | US
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Telephone | 336-802-2080
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Fax | 336-802-2081
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Authorized Official
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Title or Position | SR VP CLINICAL OPERATIONS
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Name | CRAIG MICHAEL GREVEN
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Credential | MD
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Telephone | 336-716-1331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology 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 | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) 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 | 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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