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NPI Code Detail

MEDICARE: MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA

MEDICARE: MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1073043436
Entity Type Code : Organization
Provider Name (Legal Business Name) : MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA
Provider Business Mailing Address
First Line : 1616 E MILLBROOK RD STE 110
Second Line :
City : RALEIGH
State : NC
Zip : 27609-4971
Country : US
Telephone Number : 919-341-4016
Fax Number : 910-346-1907
Provider Business Practice Location Address
First Line : 130 CARDINAL DR
Second Line :
City : ROANOKE RAPIDS
State : NC
Zip : 27870-4946
Country : US
Telephone Number : 252-308-0686
Fax Number : 252-308-0872
Authorized Official
Title or Position : MANAGER
Name : MR. PAUL FENECK
Credential :
Telephone Number : 919-341-4016
Provider Enumeration Date : 06/18/2017
Last Update Date : 01/21/2020

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Directions to “MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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