Graduated: 2017
NPI: 1912427576
Practice Locations (2)
WAKE FOREST EMERGENCY PROVIDERS
920 CHURCH ST N
CONCORD, NC 280252927
7044033000
VIDANT MEDICAL GROUP LLC
4800 S CROATAN HWY, OUTER BANKS HOSPITAL
NAGS HEAD, NC 279599704
2524495645
Source: CMS National Downloadable File, September 2026.