Provider First Line Business Practice Location Address:
EMERGENCY MEDICINE DEPARTMENT MEADS HL FL 2
Provider Second Line Business Practice Location Address:
WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157-3754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-4629
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2016