Provider First Line Business Practice Location Address:
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER
Provider Second Line Business Practice Location Address:
MEDICAL CENTER BOULEVARD
Provider Business Practice Location Address City Name:
WINSTON-SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157-1099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-4745
Provider Business Practice Location Address Fax Number:
336-716-5075
Provider Enumeration Date:
06/12/2007