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DR. BRUCE DOUGLAS WALLEY MD
NPI 1891771879
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Winston Salem, NC

Active since December 21, 2005
4622 COUNTRY CLUB RD, SUITE 180, WINSTON SALEM, NC 27104(336) 768-9535(336) 768-4155 Get Directions Write a Review

NPPES record last updated: September 11, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Bruce Douglas Walley Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRUCE DOUGLAS WALLEY MD (NPI 1891771879) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Winston Salem, North Carolina, licensed in North Carolina (19421) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1891771879
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameDR. BRUCE DOUGLAS WALLEYCredential: MD
Location Address4622 COUNTRY CLUB RD, SUITE 180Winston Salem, NC 27104-3770
Mailing Address4622 Country Club Rd, Suite 180Winston Salem, NC 27104-3770 · (336) 768-9535 · Fax (336) 768-4155
Phone(336) 768-9535
Fax(336) 768-4155
Sole ProprietorNo
Enumeration DateDecember 21, 2005
Last NPPES UpdateSeptember 11, 2008
✔ NPI 1891771879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in NC · 19421
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
4622 COUNTRY CLUB RD, Winston Salem, NC 27104
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Other Identifiers 3

Medicare UPINC86978
Medicare ID-Type Unspecified211268NC
Medicaid8985520NC

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRANDON JENKINS DMD
Dentist (General Practice)
4622 COUNTRY CLUB RD
WINSTON SALEM, NC 27104
Forsyth County (336) 765-3357
DR. JOEL CLARENCE MORGAN MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4622 COUNTRY CLUB RD, SUITE 180
WINSTON SALEM, NC 27104
Forsyth County (336) 768-9535
DR. DAVID ALLEN DUNCAN MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4622 COUNTRY CLUB RD, SUITE 180
WINSTON-SALEM, NC 27104
Forsyth County (336) 768-9535
SAMUEL PORTER JACKS MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4622 COUNTRY CLUB RD, SUITE 180
WINSTON SALEM, NC 27104
Forsyth County (336) 768-9535
NOVANT HEALTH MEDICAL GROUP, LLC
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4622 COUNTRY CLUB RD, SUITE 180
WINSTON SALEM, NC 27104
Forsyth County (336) 768-9535
DR. RONALD WILLIAM LOGAN JR. D.D.S.
Dentist (General Practice)
4622 COUNTRY CLUB RD, SUITE 240
WINSTON SALEM, NC 27104
Forsyth County (336) 760-9400
JESSICA NICIA STRICKLAND
Physician Assistant
4622 COUNTRY CLUB RD, SUITE 180
WINSTON SALEM, NC 27104
Forsyth County (336) 768-9535
DRS J LOVELAND AND R WALKER II, PLLC
Clinic/Center (Dental)
4622 COUNTRY CLUB RD
WINSTON SALEM, NC 27104
Forsyth County (336) 765-3357

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Walley's NPI number?

The NPI number for Bruce Walley is 1891771879. It was assigned to this individual provider in the NPPES registry on December 21, 2005.

Where is Bruce Walley located?

Bruce Walley practices at 4622 Country Club Rd Suite 180, Winston Salem, NC 27104. The listed phone number is (336) 768-9535.

What is Bruce Walley's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

When was this NPI record last updated?

The NPPES record for Bruce Walley was last updated on September 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.