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General NPI Number Information
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NPI Number | 1326105016
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL FAMILY CLINIC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 2105 MAPLE AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-6853
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Country | US
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Telephone | 336-570-0010
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Fax | 336-570-0012
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Provider Business Mailing Address
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Address Line | 2105 MAPLE AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-6853
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Country | US
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Telephone | 336-570-0010
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Fax | 336-570-0012
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID A. STEIN
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Credential | MD
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Telephone | 336-570-0010
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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 | 0099-01649
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License Number State | NC
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