Provider Demographics
NPI:1699732230
Name:FORSYTH CARDIOLOGY ASSOCIATES, PA
Entity type:Organization
Organization Name:FORSYTH CARDIOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF QUALITY AND RISK OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-802-2406
Mailing Address - Street 1:3073 TRENWEST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3207
Mailing Address - Country:US
Mailing Address - Phone:336-768-0437
Mailing Address - Fax:336-768-0433
Practice Address - Street 1:3073 TRENWEST DR
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3207
Practice Address - Country:US
Practice Address - Phone:336-768-0437
Practice Address - Fax:336-768-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01554OtherBCNC
NC4648908OtherAETNA
NCCI0194OtherRAILROAD MEDICARE
NC8901554Medicaid
NC8901554Medicaid