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General NPI Number Information
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NPI Number | 1548290265
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Entity Type | Organization
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Legal Business Name | FHPG, LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1035 7 LAKES DR STE C
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City | WEST END
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State | NC
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Zip | 27376-9081
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Country | US
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Telephone | 910-673-0045
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Fax | 910-673-5705
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Provider Business Mailing Address
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Address Line | 1035 7 LAKES DR STE C
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City | WEST END
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State | NC
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Zip | 27376-9081
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Country | US
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Telephone | 910-673-0045
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Fax | 910-673-5705
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Authorized Official
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Title or Position | CEO
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Name | MICKEY FOSTER
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Credential |
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Telephone | 910-715-4473
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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 | 103285
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License Number State | NC
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