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General NPI Number Information
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NPI Number | 1265148944
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE AND URGENT CARE OF NASHVILLE, PLLC
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 107 W NASHVILLE DR STE A
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City | NASHVILLE
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State | NC
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Zip | 27856-1289
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Country | US
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Telephone | 252-676-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 107 W NASHVILLE DR STE A
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City | NASHVILLE
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State | NC
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Zip | 27856-1289
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Country | US
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Telephone | 252-676-8285
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Fax | 252-382-0788
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | SHANDAL EMANUEL
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Credential | MD
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Telephone | 252-676-8285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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