| Fayetteville Internal Medicine Pllc | |
|
1766 Metromedical Dr Fayetteville NC 28304-3861 | |
| (910) 483-4856 | |
| Not Available |
| Full Name | Fayetteville Internal Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1766 Metromedical Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Jennifer Fortin (OFFICE MANAGER) |
| Authorized Official Contact | 9104834680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayetteville Internal Medicine Pllc 1766 Metromedical Dr Fayetteville NC 28304-3861 Ph: (910) 483-4856 | Fayetteville Internal Medicine Pllc 1766 Metromedical Dr Fayetteville NC 28304-3861 Ph: (910) 483-4856 |
| NPI Number | 1417684135 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 06/25/2024 |
| Medicare PECOS PAC ID | 9830555770 |
|---|---|
| Medicare Enrollment ID | O20230518000765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417684135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Debbie Cribb Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437827490 PECOS PAC ID: 6204226376 Enrollment ID: I20220524000337 |
| Provider Name | Ann Gilchrist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144541822 PECOS PAC ID: 4789818618 Enrollment ID: I20230616000802 |
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