| Fayetteville Endocrinology And Diabetes Clinic Pa | |
|
105 Roxie Ave Fayetteville NC 28304-2123 | |
| (910) 609-1880 | |
| (910) 609-1836 |
| Full Name | Fayetteville Endocrinology And Diabetes Clinic Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 105 Roxie Ave, Fayetteville, North Carolina |
| Authorized Official Name and Position | Syed Asif Raza Rizvi (PRESIDENT) |
| Authorized Official Contact | 9106091880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayetteville Endocrinology And Diabetes Clinic Pa Po Box 87186 Fayetteville NC 28304-7186 Ph: (910) 609-1880 | Fayetteville Endocrinology And Diabetes Clinic Pa 105 Roxie Ave Fayetteville NC 28304-2123 Ph: (910) 609-1880 |
| NPI Number | 1851427991 |
|---|---|
| Provider Enumeration Date | 02/25/2007 |
| Last Update Date | 12/20/2007 |
| Medicare PECOS PAC ID | 8123268141 |
|---|---|
| Medicare Enrollment ID | O20130715000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851427991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 9401482 (North Carolina) | Primary |
| Provider Name | Syed A Rizvi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1972639003 PECOS PAC ID: 5092771790 Enrollment ID: I20041204000053 |
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