Healthcare Provider Details

I. General information

NPI: 1609925668
Provider Name (Legal Business Name): CARDINAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 PURDUE DR STE 200
FAYETTEVILLE NC
28303-5510
US

IV. Provider business mailing address

1540 PURDUE DR STE 200
FAYETTEVILLE NC
28303-5510
US

V. Phone/Fax

Practice location:
  • Phone: 910-867-8889
  • Fax:
Mailing address:
  • Phone: 910-867-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MARK A WESTRICK
Title or Position: QI MANAGER
Credential:
Phone: 910-222-6234