Healthcare Provider Details

I. General information

NPI: 1891650073
Provider Name (Legal Business Name): NOBLECARE MED, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5844 WATERS EDGE DR
FAYETTEVILLE NC
28314-1062
US

IV. Provider business mailing address

5844 WATERS EDGE DR
FAYETTEVILLE NC
28314-1062
US

V. Phone/Fax

Practice location:
  • Phone: 336-701-0313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MARTINEZ
Title or Position: OWNER
Credential: PA-C
Phone: 336-701-0313