| Mcpc-23, Llc | |
|
35 Memorial Dr Pinehurst NC 28374-8708 | |
| (910) 715-5481 | |
| (910) 715-5745 |
| Full Name | Mcpc-23, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 35 Memorial Dr, Pinehurst, North Carolina |
| Authorized Official Name and Position | Mickey Foster (CEO) |
| Authorized Official Contact | 9107154473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcpc-23, Llc Po Box 896208 Charlotte NC 28289-6208 Ph: (910) 715-5481 | Mcpc-23, Llc 35 Memorial Dr Pinehurst NC 28374-8708 Ph: (910) 715-5481 |
| NPI Number | 1669123931 |
|---|---|
| Provider Enumeration Date | 01/18/2022 |
| Last Update Date | 12/17/2024 |
| Medicare PECOS PAC ID | 6002292513 |
|---|---|
| Medicare Enrollment ID | O20221007000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669123931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Jaspaul S Jawanda |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1174579726 PECOS PAC ID: 6709850449 Enrollment ID: I20040819001354 |
| Provider Name | Gretchen S Arnoczy |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326264839 PECOS PAC ID: 4385793975 Enrollment ID: I20090602000119 |
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