| Southern Internal Medicine, Pc | |
|
3514 Village Dr Fayetteville NC 28304-4554 | |
| (910) 426-0091 | |
| (910) 426-0093 |
| Full Name | Southern Internal Medicine, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3514 Village Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Shashikant J Patel (MD) |
| Authorized Official Contact | 9104260091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Internal Medicine, Pc 3514 Village Dr Fayetteville NC 28304-4554 Ph: (910) 426-0091 | Southern Internal Medicine, Pc 3514 Village Dr Fayetteville NC 28304-4554 Ph: (910) 426-0091 |
| NPI Number | 1982778049 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 10/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982778049 | NPI | - | NPPES |
| 891208P | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 130620 (North Carolina) | Primary |
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