MEDICARE: JOHN FRANK CONFORTI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	96 00493	NC
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	9600493	NC
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	96 00493	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	23901	OTHER	NC	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5298321	OTHER	NC	AETNA
7	802063	OTHER	NC	PARTNERS
8	C0869	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1639153489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN FRANK CONFORTI DO

Provider Business Mailing Address
First Line	:	3001 LYNDHURST AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-4007
Country	:	US
Telephone Number	:	336-765-0383
Fax Number	:	336-760-6918

Provider Business Practice Location Address
First Line	:	3001 LYNDHURST AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-4007
Country	:	US
Telephone Number	:	336-765-0383
Fax Number	:	336-760-6918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	11/14/2022

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Directions to “ JOHN FRANK CONFORTI DO” Practice Location

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