| Rayconda Internal Medicine | |
|
6977 Nexus Court Suite 101 Fayetteville NC 28304-2651 | |
| (910) 864-7933 | |
| (910) 864-3180 |
| Full Name | Rayconda Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 6977 Nexus Court, Fayetteville, North Carolina |
| Authorized Official Name and Position | Jagdish Lal (OWNER PHYSICIAN) |
| Authorized Official Contact | 9108647933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rayconda Internal Medicine Po Box 25217 Fayetteville NC 28314 Ph: (910) 864-7933 | Rayconda Internal Medicine 6977 Nexus Court Suite 101 Fayetteville NC 28304-2651 Ph: (910) 864-7933 |
| NPI Number | 1053338947 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 06/28/2010 |
| Medicare PECOS PAC ID | 1052504230 |
|---|---|
| Medicare Enrollment ID | O20101020000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053338947 | NPI | - | NPPES |
| 0438753 | Other | UHC | |
| 12136 | Other | BCBS | |
| 084806830 | Other | TRICARE | |
| 8912136 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9900578 (North Carolina) | Primary |
| Provider Name | Jagdish Lal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083802763 PECOS PAC ID: 3072706266 Enrollment ID: I20101020000732 |
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