Provider First Line Business Practice Location Address:
WAKE FOREST BAPTIST HEALTH
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PEDIATRICS
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-850-9008
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2007