Old Town Family Medicine, P a
NPI #1447370101 in Winston Salem, North Carolina
Provider Information
- NPI Number
- 1447370101
- Entity Type
- Organization
- Organization Name
- Old Town Family Medicine, P a
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Mar 29, 2007
- Last Updated
- Jan 26, 2012
Practice Location
- Address
- 3690 REYNOLDA RD
- City
- Winston Salem
- State
- North Carolina
- ZIP Code
- 27106-2230
- Phone
- (336) 922-1363
Authorized Official
- Name
- RICHARD RAY HERBER, MD
- Title
- PRESIDENT
- Phone
- (336) 922-1363
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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