Provider First Line Business Practice Location Address:
WAKE FOREST SCHOOL OF MEDICINE
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:
27157-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-3850
Provider Business Practice Location Address Fax Number:
336-716-3857
Provider Enumeration Date:
02/16/2026