Healthcare Provider Details

I. General information

NPI: 1609186790
Provider Name (Legal Business Name): STEDMAN-WADE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 MURCHISON RD
FAYETTEVILLE NC
28301-3517
US

IV. Provider business mailing address

2313 MURCHISON RD
FAYETTEVILLE NC
28301-3517
US

V. Phone/Fax

Practice location:
  • Phone: 910-483-6694
  • Fax:
Mailing address:
  • Phone: 910-483-6694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARGARET COVINGTON
Title or Position: CEO
Credential:
Phone: 910-483-6694