Healthcare Provider Details

I. General information

NPI: 1972667368
Provider Name (Legal Business Name): CAPE FEAR PULMONARY ASSOCIATES,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 WALTER REED RD
FAYETTEVILLE NC
28304-4437
US

IV. Provider business mailing address

1201 WALTER REED RD
FAYETTEVILLE NC
28304-4437
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-4733
  • Fax: 910-323-2097
Mailing address:
  • Phone: 910-323-4733
  • Fax: 910-323-2097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAYESH B DAVE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 910-323-4733