Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Club Haven Family Practice PA

Organization Family Medicine Physician · NPI 1922323948

Club Haven Family Practice PA is a Family Medicine Physician in Winston Salem, North Carolina. Registered with an NPI since 2010.

In the registry since
2010
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2801 Lyndhurst Ave
Winston Salem, NC 27103-4109
Phone: (336) 768-9575
Fax: (336) 774-1737
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1922323948
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Hatley — Practice Manager · (336) 768-9575
NPI enumeratedApril 1, 2010
Last updated in NPPESApril 30, 2015
Mailing address2801 Lyndhurst Ave, Winston Salem, NC 27103-4109

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