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General NPI Number Information
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NPI Number | 1255388369
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Entity Type | Organization
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Legal Business Name | PINEHURST MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 205 PAGE RD
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City | PINEHURST
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State | NC
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Zip | 28374-8798
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Country | US
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Telephone | 910-295-5511
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Fax | 910-235-3443
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Provider Business Mailing Address
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Address Line | 200 PAVILION WAY
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4561
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Country | US
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Telephone | 910-295-5511
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Fax | 910-235-2690
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Authorized Official
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Title or Position | CEO
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Name | MR. BRANDON ENFINGER
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Credential |
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Telephone | 910-235-3004
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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 | 39578
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #9
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #10
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #11
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 39578
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License Number State | NC
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Taxonomy #12
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 39578
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License Number State | NC
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Taxonomy #13
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 39578
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License Number State | NC
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