Southern Internal Medicine, Pc | |
3514 Village Dr Fayetteville NC 28304-4554 | |
(910) 426-0091 | |
(910) 426-0093 |
Full Name | Southern Internal Medicine, Pc |
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Speciality | Internal Medicine |
Location | 3514 Village Dr, Fayetteville, North Carolina |
Authorized Official Name and Position | Shashikant J Patel (MD) |
Authorized Official Contact | 9104260091 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southern Internal Medicine, Pc 3514 Village Dr Fayetteville NC 28304-4554 Ph: (910) 426-0091 | Southern Internal Medicine, Pc 3514 Village Dr Fayetteville NC 28304-4554 Ph: (910) 426-0091 |
NPI Number | 1982778049 |
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Provider Enumeration Date | 11/20/2006 |
Last Update Date | 10/17/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982778049 | NPI | - | NPPES |
891208P | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 130620 (North Carolina) | Primary |
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