Healthcare Provider Details

I. General information

NPI: 1730066614
Provider Name (Legal Business Name): CAPE FEAR VALLEY HEALTH MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 OWEN DR
FAYETTEVILLE NC
28304-3424
US

IV. Provider business mailing address

PO BOX 40908
FAYETTEVILLE NC
28309-0908
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-2626
  • Fax: 910-484-7962
Mailing address:
  • Phone: 910-615-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH BARTON FISER
Title or Position: VP MANAGED CARE/REVENUE CYCLE
Credential:
Phone: 910-615-5572