MEDICARE: MONROE FAMILY MEDICAL CENTER, P.A.

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
1	207Q00000X	Family Medicine Physician		NC
2	207R00000X	Internal Medicine Physician		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	02200	OTHER	NC	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1215992698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONROE FAMILY MEDICAL CENTER, P.A.

Provider Business Mailing Address
First Line	:	1420 E FRANKLIN ST
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-5160
Country	:	US
Telephone Number	:	704-289-8427
Fax Number	:	704-283-5522

Provider Business Practice Location Address
First Line	:	1420 E FRANKLIN ST
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-5160
Country	:	US
Telephone Number	:	704-289-8427
Fax Number	:	704-283-5522

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLAIM C DESKINS
Credential	:	M.D.
Telephone Number	:	704-289-8427

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	09/11/2025

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