| |
6602 Knightdale Blvd Ste 202 Knightdale NC 27545-6526 | |
(919) 747-5270 | |
(919) 747-5271 |
Full Name | |
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Speciality | Family Medicine |
Location | 6602 Knightdale Blvd Ste 202, Knightdale, North Carolina |
Authorized Official Name and Position | Lynne Christine Fiscus (CMO) |
Authorized Official Contact | 9842154111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5221 Paramount Pkwy Ste 220 Morrisville NC 27560-5490 Ph: () - | 6602 Knightdale Blvd Ste 202 Knightdale NC 27545-6526 Ph: (919) 747-5270 |
NPI Number | 1164710810 |
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Provider Enumeration Date | 07/15/2011 |
Last Update Date | 01/16/2025 |
Identifier | Type | State | Issuer |
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1164710810 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |