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General NPI Number Information
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NPI Number | 1902614464
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Entity Type | Organization
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Legal Business Name | CAPE FEAR VALLEY HEALTH MEDICAL GROUP LLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 2301 ROBESON ST STE 203
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5641
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Country | US
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Telephone | 910-615-3220
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Fax | 910-486-2170
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Provider Business Mailing Address
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Address Line | PO BOX 40908
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City | FAYETTEVILLE
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State | NC
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Zip | 28309-0908
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Country | US
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Telephone | 910-615-6949
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Fax | 910-615-9761
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Authorized Official
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Title or Position | VP REVENUE CYCLE AND MANAGED CARE
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Name | JOSEPH BARTON FISER
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Credential |
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Telephone | 910-615-5572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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