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General NPI Number Information
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NPI Number | 1982291555
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Entity Type | Organization
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Legal Business Name | AMERICAN FAMILY CARE RALEIGH MIDTOWN PLLC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 2913 WAKE FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27609-7841
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Country | US
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Telephone | 919-899-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5943
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-0943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JAMES EARNHARDT
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Credential | MD
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Telephone | 919-899-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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