| Mlp Church Md Family Practice, Inc. | |
|
1707 Industrial Dr Wilkesboro NC 28697-7345 | |
| (336) 667-6363 | |
| (336) 667-8066 |
| Full Name | Mlp Church Md Family Practice, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1707 Industrial Dr, Wilkesboro, North Carolina |
| Authorized Official Name and Position | Mary Louise Parker Church (PRESIDENT / OWNER) |
| Authorized Official Contact | 3366676363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mlp Church Md Family Practice, Inc. 1707 Industrial Dr Wilkesboro NC 28697-7345 Ph: (336) 667-6363 | Mlp Church Md Family Practice, Inc. 1707 Industrial Dr Wilkesboro NC 28697-7345 Ph: (336) 667-6363 |
| NPI Number | 1710215538 |
|---|---|
| Provider Enumeration Date | 12/07/2009 |
| Last Update Date | 12/07/2009 |
| Medicare PECOS PAC ID | 3577604578 |
|---|---|
| Medicare Enrollment ID | O20100113000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710215538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mary Church |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639170749 PECOS PAC ID: 0941341945 Enrollment ID: I20100113000560 |
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