MEDICARE: CAPE FEAR REGIONAL UROLOGICAL

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	208800000X	Urology Physician	9400496	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

General Provider Information

NPI Number	:	1255397725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE FEAR REGIONAL UROLOGICAL

Provider Business Mailing Address
First Line	:	1537 OWEN PARK LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3454
Country	:	US
Telephone Number	:	910-485-8801
Fax Number	:	910-485-5605

Provider Business Practice Location Address
First Line	:	1537 OWEN PARK LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3454
Country	:	US
Telephone Number	:	910-485-8801
Fax Number	:	910-485-5605

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SUSAN WILSON
Credential	:
Telephone Number	:	910-485-8801

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	01/09/2012

Similar Medicare Providers

1427059724 — STEPHEN CHARLES ROCHMAN MD
Practice Location Address:

1537 OWEN PARK LN
FAYETTEVILLE, NC
28304-3454

Practice Phone: 910-485-8801
Practice Fax: 910-485-5605

1205862547 — MRS. GEORGIA JAMILLAH BUCKLEY PA-C
Practice Location Address:

1536 OWEN PARK LN
FAYETTEVILLE, NC
28304-3454

Practice Phone: 910-307-1576
Practice Fax: 910-500-3117

1528161668 — ERNESTO J F GRAHAM MD PA
Practice Location Address:

1521 OWEN PARK LN
FAYETTEVILLE, NC
28304-3454

Practice Phone: 910-223-7420
Practice Fax:

1548424104 — OWEN PARK PEDIATRICS, PA
Practice Location Address:

1520 OWEN PARK LN
FAYETTEVILLE, NC
28304-3454

Practice Phone: 910-860-3500
Practice Fax: 910-485-3507

1376771501 — MRS. APRIL GANT MSN, FNP-BC
Practice Location Address:

1521 OWEN PARK LN
FAYETTEVILLE, NC
28304-3454

Practice Phone: 910-321-6006
Practice Fax: 910-321-6007

1265762173 — MRS. BELINDA KAYDIANNE FUGALLI PA-C
Practice Location Address:

1537 OWEN PARK LN
FAYETTEVILLE, NC
28304-3454

Practice Phone: 910-485-8801
Practice Fax: 910-485-5605

Directions to “CAPE FEAR REGIONAL UROLOGICAL ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.