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General NPI Number Information
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NPI Number | 1033171327
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Entity Type | Organization
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Legal Business Name | RIVERBEND FAMILY MEDICINE, PA
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 1006 PROCURE ST
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City | FUQUAY VARINA
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State | NC
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Zip | 27526
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Country | US
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Telephone | 919-577-9952
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Fax | 919-577-9946
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Provider Business Mailing Address
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Address Line | 1006 PROCURE ST
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City | FUQUAY VARINA
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State | NC
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Zip | 27526
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Country | US
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Telephone | 919-577-9952
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Fax | 919-577-9946
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | OFFICE MANAGER
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Credential |
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Telephone | 919-577-9952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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