| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 801 Poole Dr, Garner, North Carolina |
| Authorized Official Name and Position | Robert Louis Gianforcaro (DIRECTOR) |
| Authorized Official Contact | 9199230660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1600 Perimeter Park Dr Suite #225 Morrisville NC 27560-8421 Ph: () - | 801 Poole Dr Garner NC 27529-5207 Ph: (919) 779-1440 |
| NPI Number | 1154695070 |
|---|---|
| Provider Enumeration Date | 02/24/2012 |
| Last Update Date | 06/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154695070 | NPI | - | NPPES |
| 5919967 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (North Carolina) | Primary |
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