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

Wake Forest Health Network LLC

Organization Pediatrics Physician · NPI 1063647394

Wake Forest Health Network LLC is a Pediatrics Physician in Winston Salem, North Carolina. Registered with an NPI since 2009.

In the registry since
2009
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2933 Maplewood Ave
Winston Salem, NC 27103-4009
Phone: (336) 794-3380
Fax: (336) 794-3378
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1063647394
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Craig Greven — Sr Vp Clinical Operations · (336) 716-1331
Other names Atrium Health Wake Forest Baptist Pediatrics - Ford Simpson Lively & R
NPI enumeratedMay 15, 2009
Last updated in NPPESSeptember 25, 2025
Certification dateSeptember 25, 2025
Mailing address2933 Maplewood Ave Ste 1, Winston Salem, NC 27103-4001

Other providers in Winston Salem