Healthcare Provider Details
I. General information
NPI: 1265368393
Provider Name (Legal Business Name): RAINBOW PEDIATRICS OF FAYETTEVILLE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4300 FAYETTEVILLE RD
LUMBERTON NC
28358-2677
US
IV. Provider business mailing address
4300 FAYETTEVILLE RD
LUMBERTON NC
28358-2677
US
V. Phone/Fax
- Phone: 910-276-7570
- Fax:
- Phone: 214-600-4184
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
DOUGLAS
HAIN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 910-276-7570