Provider Demographics
NPI:1831567445
Name:WAKE FOREST HEALTH NETWORK LLC
Entity type:Organization
Organization Name:WAKE FOREST HEALTH NETWORK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GREVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-716-1331
Mailing Address - Street 1:1814 WESTCHESTER DR STE 302
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7369
Mailing Address - Country:US
Mailing Address - Phone:336-802-2170
Mailing Address - Fax:336-802-2026
Practice Address - Street 1:1814 WESTCHESTER DR
Practice Address - Street 2:STE 302
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7299
Practice Address - Country:US
Practice Address - Phone:336-802-2170
Practice Address - Fax:336-802-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty