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NPI Code Detail

MEDICARE: LUBICA FEDOR M.D.

MEDICARE:   LUBICA  FEDOR  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician34309NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780635300
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUBICA FEDOR M.D.
Provider Business Mailing Address
First Line : 1277 DRIVERS CIR
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-9615
Country : US
Telephone Number : 252-443-5451
Fax Number : 252-442-4312
Provider Business Practice Location Address
First Line : 112 N CIRCLE DR
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-2430
Country : US
Telephone Number : 252-443-5451
Fax Number : 252-442-4312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 07/08/2007

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