Ferncreek Primary Care, Pc | |
1314 Medical Dr Ste 102 Fayetteville NC 28304 | |
(910) 491-3922 | |
(910) 491-5350 |
Full Name | Ferncreek Primary Care, Pc |
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Speciality | Internal Medicine |
Location | 1314 Medical Dr Ste 102, Fayetteville, North Carolina |
Authorized Official Name and Position | Pravinkumar K Patel (PRESIDENT) |
Authorized Official Contact | 9104913922 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ferncreek Primary Care, Pc 1314 Medical Dr Ste 102 Fayetteville NC 28304-4421 Ph: (910) 491-3922 | Ferncreek Primary Care, Pc 1314 Medical Dr Ste 102 Fayetteville NC 28304 Ph: (910) 491-3922 |
NPI Number | 1992171078 |
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Provider Enumeration Date | 08/12/2015 |
Last Update Date | 05/24/2018 |
Medicare PECOS PAC ID | 4688977713 |
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Medicare Enrollment ID | O20160125001229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992171078 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Pravinkumar Kantilal Patel |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669449179 PECOS PAC ID: 3870675937 Enrollment ID: I20101215000192 |
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