Healthcare Provider Details

I. General information

NPI: 1194765362
Provider Name (Legal Business Name): FAYETTEVILLE WOMANS CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 VALLEYGATE DR
FAYETTEVILLE NC
28304-3688
US

IV. Provider business mailing address

2029 VALLEYGATE DR SUITE 101
FAYETTEVILLE NC
28304-3688
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-2103
  • Fax: 910-323-2219
Mailing address:
  • Phone: 910-323-2103
  • Fax: 910-323-2219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MYRON SCOTT STRICKLAND
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 910-323-2103