| Spectrum Internal Medicine, Pllc | |
|
2944 Breezewood Ave Suite 101 Fayetteville NC 28303-5415 | |
| (910) 323-1800 | |
| (910) 323-4030 |
| Full Name | Spectrum Internal Medicine, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2944 Breezewood Ave, Fayetteville, North Carolina |
| Authorized Official Name and Position | Dipa Parikh (MANAGER) |
| Authorized Official Contact | 9103231800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Internal Medicine, Pllc Po Box 87022 Fayetteville NC 28304-7022 Ph: (910) 323-1800 | Spectrum Internal Medicine, Pllc 2944 Breezewood Ave Suite 101 Fayetteville NC 28303-5415 Ph: (910) 323-1800 |
| NPI Number | 1265433684 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 04/26/2023 |
| Medicare PECOS PAC ID | 4789651159 |
|---|---|
| Medicare Enrollment ID | O20040914001411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265433684 | NPI | - | NPPES |
| 016AU | Other | NC | BCBS |
| 89016AU | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Roshan P Parikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821099961 PECOS PAC ID: 5597732966 Enrollment ID: I20040917000914 |
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