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General NPI Number Information
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NPI Number | 1124007620
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Entity Type | Organization
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Legal Business Name | CAPITAL FAMILY MEDICINE, P.A.
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3320 EXECUTIVE DR SUITE 214
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City | RALEIGH
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State | NC
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Zip | 27609-7445
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Country | US
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Telephone | 919-878-8596
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Fax | 919-878-0744
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Provider Business Mailing Address
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Address Line | 3320 EXECUTIVE DR SUITE 214
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City | RALEIGH
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State | NC
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Zip | 27609-7445
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Country | US
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Telephone | 919-878-8596
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Fax | 919-878-0744
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD J FORSYTH
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Credential | M.D.
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Telephone | 919-878-8596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 40821
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License Number State | NC
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