Healthcare Provider Details
I. General information
NPI: 1093737975
Provider Name (Legal Business Name): NOVA MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2006
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2991 CROUSE LN
BURLINGTON NC
27215-8833
US
IV. Provider business mailing address
2991 CROUSE LN
BURLINGTON NC
27215-8833
US
V. Phone/Fax
- Phone: 336-586-0994
- Fax: 336-586-9363
- Phone: 336-586-0994
- Fax: 336-586-9363
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MUHAMMAD
YUNUS
Title or Position: OFFICE MANAGER
Credential:
Phone: 336-586-0994