Individual ProviderGwendolyn Mary Wigand BollingInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1381 Westgate Center Dr, Winston Salem, NC 27103-2934(336) 718-0100PECOS EnrollmentBased on the most recent information from CMS, provider Gwendolyn Mary Wigand Bolling does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1902892086Provider TypeIndividualFull NameWigand Bolling, Gwendolyn MaryTitleMrs.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date9/23/2005Last Updated4/26/2023Contact InformationPractice LocationPractice Address1381 Westgate Center Dr, Winston Salem, NC 27103-2934Phone(336) 718-0100Fax(336) 718-0120Mailing LocationMailing AddressPO Box 751803, Charlotte, NC 28275-1803Phone(336) 718-0100Fax(336) 718-0120Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense2000001333North CarolinaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense2000001333North CarolinaProvider IdentifiersIDDescriptionIssuerID89128ETDescriptionMedicaidIssuerUnlistedNorth Carolina