Healthcare Provider Details
I. General information
NPI: 1477444255
Provider Name (Legal Business Name): CHILDREN'S URGENT CARE OF FAYETTEVILLE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4118 RAEFORD RD
FAYETTEVILLE NC
28304-3360
US
IV. Provider business mailing address
5175 LAKEWOOD DR
FAYETTEVILLE NC
28306-4578
US
V. Phone/Fax
- Phone: 901-413-9657
- Fax: 472-215-8665
- Phone: 901-413-9657
- Fax: 472-215-8665
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WAREES
M
WAREES
Title or Position: CEO
Credential: MD
Phone: 901-413-9657