Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Club Haven Family Practice PA

Organization Family Medicine Physician · NPI 1922323948

Club Haven Family Practice PA provides Family Medicine Physician services 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.

See every abbreviation used in this directory →

Practice location Address checks out

2801 Lyndhurst Ave
Winston Salem, NC 27103-4109 Not confirmed with CMS for 11 years — call before visiting
Phone: (336) 768-9575
Fax: (336) 774-1737
Show map & directions

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

Other providers in Winston Salem