Provider First Line Business Practice Location Address:
WAKE FOREST BAPTIST MEDICAL CTR
Provider Second Line Business Practice Location Address:
MEDICAL CENTER BLVD, CARE COORDINATION DEPT
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-7964
Provider Business Practice Location Address Fax Number:
336-716-9338
Provider Enumeration Date:
02/09/2007