Healthcare Provider Details

I. General information

NPI: 1629841788
Provider Name (Legal Business Name): FASTMED P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 NC HIGHWAY 751
DURHAM NC
27707-5733
US

IV. Provider business mailing address

4613 UNIVERSITY DR
DURHAM NC
27707-3458
US

V. Phone/Fax

Practice location:
  • Phone: 919-313-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JIM MOFFETT
Title or Position: CEO
Credential:
Phone: 919-550-0821