| Id Care Of Nc Pa | |
|
1319 Avon St Fayetteville NC 28304-4423 | |
| (910) 729-6552 | |
| (910) 500-1002 |
| Full Name | Id Care Of Nc Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1319 Avon St, Fayetteville, North Carolina |
| Authorized Official Name and Position | Vipul A Savaliya (PRESIDENT) |
| Authorized Official Contact | 9105683903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Care Of Nc Pa 1319 Avon St Fayetteville NC 28304-4423 Ph: (910) 729-6552 | Id Care Of Nc Pa 1319 Avon St Fayetteville NC 28304-4423 Ph: (910) 729-6552 |
| NPI Number | 1033667761 |
|---|---|
| Provider Enumeration Date | 09/12/2016 |
| Last Update Date | 02/27/2018 |
| Medicare PECOS PAC ID | 0345529988 |
|---|---|
| Medicare Enrollment ID | O20161122001418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033667761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 2014-00955 (North Carolina) | Primary |
| Provider Name | Obiefuna Perry Okoye |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740234434 PECOS PAC ID: 2062414220 Enrollment ID: I20070201000327 |
| Provider Name | Elizabeth Elizabeth Onyeaso |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1396037883 PECOS PAC ID: 2163663204 Enrollment ID: I20130801000138 |
| Provider Name | Vipul A Savaliya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528339660 PECOS PAC ID: 2961629803 Enrollment ID: I20140815002325 |
| Provider Name | Valerie Barlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366955189 PECOS PAC ID: 4688937147 Enrollment ID: I20180416000000 |
| Provider Name | Lindsay K Shumate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558761213 PECOS PAC ID: 2163729443 Enrollment ID: I20180724002292 |
| Provider Name | Sierra Burke Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740758341 PECOS PAC ID: 4082953773 Enrollment ID: I20190225000100 |
| Provider Name | Ann L Doty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356876866 PECOS PAC ID: 3375895774 Enrollment ID: I20191202001535 |
| Provider Name | Rinali K Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588293575 PECOS PAC ID: 7012348188 Enrollment ID: I20200506001296 |
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Greenbrook Tms Fayetteville Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1991 Fordham Dr Ste 202, Fayetteville, NC 28304 Phone: 855-910-4867 |