| NPI | 1487879177 |
|---|---|
| Doing Business As | ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KERNERSVILLE SPORTS COM |
| Entity Type | Organization |
| Authorized Contact | RUSSELL MARS HOWERTON Sr VP Network Phys & Hs Cmo 336-716-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2023-11-29 |