| Crescent Family Practice, P.a. | |
|
1110 S.e. Cary Parkway Ste 203 Cary NC 27518-7420 | |
| (919) 851-7867 | |
| (919) 851-7866 |
| Full Name | Crescent Family Practice, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1110 S.e. Cary Parkway, Cary, North Carolina |
| Authorized Official Name and Position | Joseph Walter Bruckert (PRESIDENT) |
| Authorized Official Contact | 9198517867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Family Practice, P.a. 1110 S.e. Cary Parkway Ste 203 Cary NC 27518-7420 Ph: (919) 851-7867 | Crescent Family Practice, P.a. 1110 S.e. Cary Parkway Ste 203 Cary NC 27518-7420 Ph: (919) 851-7867 |
| NPI Number | 1629129952 |
|---|---|
| Provider Enumeration Date | 01/15/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4486745650 |
|---|---|
| Medicare Enrollment ID | O20070802000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629129952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0039359 (North Carolina) | Primary |
| Provider Name | Joseph W Bruckert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306993019 PECOS PAC ID: 5092806265 Enrollment ID: I20100730000146 |
| Provider Name | Corey W Musselman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497802193 PECOS PAC ID: 9739270901 Enrollment ID: I20100807000061 |
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