| Fayetteville Geriatric & Internal Medicine Clinic Pa | |
|
3616 Cape Center Dr Suite A Fayetteville NC 28304 | |
| (910) 868-6730 | |
| (910) 829-9649 |
| Full Name | Fayetteville Geriatric & Internal Medicine Clinic Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3616 Cape Center Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Mohammed Rahman (DOCTOR) |
| Authorized Official Contact | 9108686730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayetteville Geriatric & Internal Medicine Clinic Pa Po Box 1689 Etowah NC 28729-1689 Ph: (828) 891-5524 | Fayetteville Geriatric & Internal Medicine Clinic Pa 3616 Cape Center Dr Suite A Fayetteville NC 28304 Ph: (910) 868-6730 |
| NPI Number | 1649373788 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 06/11/2014 |
| Medicare PECOS PAC ID | 4981743960 |
|---|---|
| Medicare Enrollment ID | O20091204000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649373788 | NPI | - | NPPES |
| 891163K | Medicaid | NC | |
| 1163K | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mohammed W. Rahman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942232384 PECOS PAC ID: 7719995133 Enrollment ID: I20060327000860 |
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