| Spectrum Family Medicine Pllc | |
|
519 Keisler Dr Ste 104 Cary NC 27518-7098 | |
| (919) 741-3186 | |
| (919) 400-4365 |
| Full Name | Spectrum Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 519 Keisler Dr Ste 104, Cary, North Carolina |
| Authorized Official Name and Position | Sujatha Sajeevan (PRESIDENT) |
| Authorized Official Contact | 9197413186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Family Medicine Pllc 222 Darbytown Pl Cary NC 27513-4279 Ph: (919) 741-3186 | Spectrum Family Medicine Pllc 519 Keisler Dr Ste 104 Cary NC 27518-7098 Ph: (919) 741-3186 |
| NPI Number | 1982131843 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 09/28/2021 |
| Medicare PECOS PAC ID | 7012287618 |
|---|---|
| Medicare Enrollment ID | O20170713003376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982131843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2009-01871 (North Carolina) | Primary |
| Provider Name | Sujatha Sajeevan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447442983 PECOS PAC ID: 4183762180 Enrollment ID: I20091112000026 |
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