Cross Creek Medical Clinic, Pa | |
1309 Medical Dr Suite 1 Fayetteville NC 28304-4425 | |
(910) 437-5130 | |
(910) 437-5130 |
Full Name | Cross Creek Medical Clinic, Pa |
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Speciality | Internal Medicine |
Location | 1309 Medical Dr, Fayetteville, North Carolina |
Authorized Official Name and Position | Nitin Dahyabhai Desai (PRESIDENT) |
Authorized Official Contact | 9104375130 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cross Creek Medical Clinic, Pa 1309 Medical Dr Suite 1 Fayetteville NC 28304-4425 Ph: (910) 437-5130 | Cross Creek Medical Clinic, Pa 1309 Medical Dr Suite 1 Fayetteville NC 28304-4425 Ph: (910) 437-5130 |
NPI Number | 1174575179 |
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Provider Enumeration Date | 05/17/2006 |
Last Update Date | 12/13/2007 |
Medicare PECOS PAC ID | 1052320892 |
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Medicare Enrollment ID | O20060406000312 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174575179 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 9600078 (North Carolina) | Primary |
Provider Name | Nitin D Desai |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245202696 PECOS PAC ID: 5597774331 Enrollment ID: I20070713000506 |
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