| Angier Pediatrics And Adult Medical Center, Pllc | |
|
441 Lakestone Commons Ave Fuquay Varina NC 27526-6972 | |
| (919) 577-0481 | |
| (919) 577-0512 |
| Full Name | Angier Pediatrics And Adult Medical Center, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 441 Lakestone Commons Ave, Fuquay Varina, North Carolina |
| Authorized Official Name and Position | Kingsley Chuks Ugochukwu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9192343517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angier Pediatrics And Adult Medical Center, Pllc 412 Howard Grove Pkwy Cary NC 27519-0802 Ph: () - | Angier Pediatrics And Adult Medical Center, Pllc 441 Lakestone Commons Ave Fuquay Varina NC 27526-6972 Ph: (919) 577-0481 |
| NPI Number | 1104096015 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 04/03/2014 |
| Medicare PECOS PAC ID | 2769551910 |
|---|---|
| Medicare Enrollment ID | O20080514000644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104096015 | NPI | - | NPPES |
| 89136U6 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kingsley C Ugochukwu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306918123 PECOS PAC ID: 5193791119 Enrollment ID: I20040909000949 |
| Provider Name | Latoshia D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548669104 PECOS PAC ID: 5991028250 Enrollment ID: I20141218000974 |
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