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General NPI Number Information
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NPI Number | 1518283613
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Entity Type | Organization
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Legal Business Name | ALPHA PRIMARY CARE
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 2325 RANDLEMAN RD
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City | GREENSBORO
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State | NC
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Zip | 27406-3603
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Country | US
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Telephone | 336-617-2377
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Fax | 336-617-2392
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Provider Business Mailing Address
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Address Line | 2325 RANDLEMAN RD
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City | GREENSBORO
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State | NC
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Zip | 27406-3603
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Country | US
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Telephone | 336-617-2377
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Fax | 336-617-2392
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. EDWIN AZIEGBE AVBUERE
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Credential | M.D.
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Telephone | 336-617-2377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2001-01168
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License Number State | NC
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