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101 Robeson St Ste 405 Fayetteville NC 28301-5520 | |
(910) 615-1623 | |
(910) 321-6248 |
Full Name | |
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Speciality | Internal Medicine |
Location | 101 Robeson St Ste 405, Fayetteville, North Carolina |
Authorized Official Name and Position | Joseph Barton Fiser (VP CORPORATE REVEUNE CYCLE) |
Authorized Official Contact | 9106155572 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 40908 Fayetteville NC 28309-0908 Ph: (910) 615-6448 | 101 Robeson St Ste 405 Fayetteville NC 28301-5520 Ph: (910) 615-1623 |
NPI Number | 1962404384 |
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Provider Enumeration Date | 08/15/2005 |
Last Update Date | 01/08/2025 |
Medicare PECOS PAC ID | 5092701771 |
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Medicare Enrollment ID | O20050524000145 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962404384 | NPI | - | NPPES |
89104UR | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
Provider Name | Nduche Chika Onyeaso |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1497045496 PECOS PAC ID: 6204074958 Enrollment ID: I20140801000966 |
Provider Name | Anju Gurung |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225285042 PECOS PAC ID: 4981728979 Enrollment ID: I20160809000363 |
Provider Name | Ashley Nicole Stone |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1013536234 PECOS PAC ID: 4981025087 Enrollment ID: I20200527003037 |
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