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General NPI Number Information
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NPI Number | 1922018704
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Entity Type | Organization
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Legal Business Name | CAROLINA FAMILY PRACTICE, P. A.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 801 W 3RD ST
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City | SILER CITY
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State | NC
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Zip | 27344-3037
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Country | US
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Telephone | 919-663-0085
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Fax | 919-663-0289
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Provider Business Mailing Address
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Address Line | 801 W 3RD ST
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City | SILER CITY
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State | NC
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Zip | 27344-3037
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Country | US
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Telephone | 919-663-0085
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Fax | 919-663-0289
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH ERIC MCMANUS
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Credential | M.D.
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Telephone | 919-663-0085
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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 | 32879
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License Number State | NC
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