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NPI Code Detail

MEDICARE: NORTH CAROLINA FAMILY DOCTOR, P.A.

MEDICARE: NORTH CAROLINA FAMILY DOCTOR, P.A.
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
1261Q00000XClinic/Center27884NC

General Provider Information

NPI Number : 1881623023
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH CAROLINA FAMILY DOCTOR, P.A.
Provider Business Mailing Address
First Line : 1728 FORDHAM BLVD
Second Line : 151 RAMS PLAZA
City : CHAPEL HILL
State : NC
Zip : 27514-2397
Country : US
Telephone Number : 919-968-1985
Fax Number : 919-942-0038
Provider Business Practice Location Address
First Line : 1728 FORDHAM BLVD
Second Line : 151 RAMS PLAZA
City : CHAPEL HILL
State : NC
Zip : 27514-2397
Country : US
Telephone Number : 919-968-1985
Fax Number : 919-942-0038
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. GLENN ASHLEY WITHROW
Credential : M.D.
Telephone Number : 919-968-1985
Provider Enumeration Date : 07/01/2006
Last Update Date : 02/27/2013

Similar Medicare Providers

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Practice Location Address:
1728 FORDHAM BLVD , 151 RAMS PLAZA
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Practice Phone: 919-968-1985
Practice Fax: 919-942-0038
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1982763306 — ANNE THERESA VAILLANCOURT PA-C
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CHAPEL HILL, NC
27514-2397
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1750441184 — BETTY JO HASWELL PA-C
Practice Location Address:
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1497898597 — WILLIAM INGRAM POWELL IV F.N.P.
Practice Location Address:
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27514-2397
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1417493008 — KRISTIN STANKEVITZ PA-C
Practice Location Address:
1728 FORDHAM BLVD
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27514-2397
Practice Phone: 919-968-1985
Practice Fax:

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