| Medical Psychiatric Providers | |
|
3200 Waterfield Dr Garner NC 27529-7727 | |
| (407) 732-7957 | |
| Not Available |
| Full Name | Medical Psychiatric Providers |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3200 Waterfield Dr, Garner, North Carolina |
| Authorized Official Name and Position | Eric Moore (OWNER) |
| Authorized Official Contact | 4077327957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Psychiatric Providers 4300 W Lake Mary Blvd Ste 1010-357 Lake Mary FL 32746-2060 Ph: (407) 732-7910 | Medical Psychiatric Providers 3200 Waterfield Dr Garner NC 27529-7727 Ph: (407) 732-7957 |
| NPI Number | 1083481824 |
|---|---|
| Provider Enumeration Date | 12/11/2023 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 7810434446 |
|---|---|
| Medicare Enrollment ID | O20240801000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083481824 | NPI | - | NPPES |
| Provider Name | Lyntressa Danielle Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083955793 PECOS PAC ID: 3375784911 Enrollment ID: I20130724000965 |
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