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General NPI Number Information
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NPI Number | 1891060398
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Entity Type | Organization
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Legal Business Name | FAYETTEVILLE URGENT CARE AND FAMILY MEDICINE PA
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Dates
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Enumeration Date | 03/16/2012
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 4155 FERNCREEK DR STE 102B
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-2576
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Country | US
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Telephone | 910-425-5999
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Fax | 910-221-1062
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Provider Business Mailing Address
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Address Line | 4155 FERNCREEK DR STE 102B
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-2576
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Country | US
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Telephone | 910-425-5999
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Fax | 910-221-1062
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Authorized Official
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Title or Position | AUTHORIZED OWNER
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Name | FLORENCE FONDINKA
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Credential |
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Telephone | 910-424-6553
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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 | 200301461
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 200301461
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License Number State | NC
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