| Brunswick Family Medicine Pa | |
|
3960 Executive Park Blvd Unit 600 Southport NC 28461 | |
| (910) 454-4343 | |
| (910) 457-9209 |
| Full Name | Brunswick Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3960 Executive Park Blvd, Southport, North Carolina |
| Authorized Official Name and Position | Slade Alan Suchecki (PRESIDENT) |
| Authorized Official Contact | 9104544343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brunswick Family Medicine Pa 3960 Executive Park Blvd Unit 600 Southport NC 28461 Ph: (910) 454-4343 | Brunswick Family Medicine Pa 3960 Executive Park Blvd Unit 600 Southport NC 28461 Ph: (910) 454-4343 |
| NPI Number | 1396859872 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 09/25/2014 |
| Medicare PECOS PAC ID | 5890898951 |
|---|---|
| Medicare Enrollment ID | O20070309000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396859872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Slade A Suchecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194839647 PECOS PAC ID: 2264535426 Enrollment ID: I20070309000112 |
| Provider Name | Rick J Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437351806 PECOS PAC ID: 1153457411 Enrollment ID: I20100326000124 |
| Provider Name | Sherrie G Cass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649736653 PECOS PAC ID: 6709128010 Enrollment ID: I20190506002041 |
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J Arthur Dosher Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 819 N Atlantic Ave, Southport, NC 28461 Phone: 910-454-4635 Fax: 855-777-2271 | |
J Arthur Dosher Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 906 N Howe Street, Southport, NC 28461 Phone: 910-457-3808 Fax: 910-457-3808 | |
Dosher Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3009 Medical Plaza Ln, Southport, NC 28461 Phone: 910-457-1234 | |
Comprehensive Medical Associates, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5130 Southport Supply Rd Se, Suite 101 A, Southport, NC 28461 Phone: 910-454-4032 Fax: 910-454-4033 |