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1000 Brown Street Faith NC 28041-0610 | |
(704) 279-3950 | |
(704) 209-3004 |
Full Name | |
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Speciality | Family Medicine |
Location | 1000 Brown Street, Faith, North Carolina |
Authorized Official Name and Position | Geoffrey Gardner (VP OF OPERATIONS) |
Authorized Official Contact | 7043849094 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-7840 | 1000 Brown Street Faith NC 28041-0610 Ph: (704) 279-3950 |
NPI Number | 1447429725 |
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Provider Enumeration Date | 02/21/2008 |
Last Update Date | 03/11/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447429725 | NPI | - | NPPES |
5950084 | Medicaid | NC | |
1447429725 | Other | NC | BCBS-NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |