| Cross Creek Neurology Pllc | |
|
518 Beaumont Rd Suite 101 Fayetteville NC 28304-4447 | |
| (910) 487-5574 | |
| (910) 487-5542 |
| Full Name | Cross Creek Neurology Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 518 Beaumont Rd, Fayetteville, North Carolina |
| Authorized Official Name and Position | Muhammed Amir Khasru (OWNER) |
| Authorized Official Contact | 9104875574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cross Creek Neurology Pllc 3533 Turnberry Circle Fayetteville NC 28303-4665 Ph: (910) 487-5574 | Cross Creek Neurology Pllc 518 Beaumont Rd Suite 101 Fayetteville NC 28304-4447 Ph: (910) 487-5574 |
| NPI Number | 1124184247 |
|---|---|
| Provider Enumeration Date | 01/01/2007 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 8426078643 |
|---|---|
| Medicare Enrollment ID | O20051202000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124184247 | NPI | - | NPPES |
| 891297A | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Muhammed Khasru |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437111804 PECOS PAC ID: 7517953243 Enrollment ID: I20040420001582 |
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