MEDICARE: CAPE FEAR VALLEY HEALTH MEDICAL GROUP LLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1861217846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE FEAR VALLEY HEALTH MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 40908
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28309-0908
Country	:	US
Telephone Number	:	910-615-6949
Fax Number	:

Provider Business Practice Location Address
First Line	:	6387 RAMSEY ST UNIT 240
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-9442
Country	:	US
Telephone Number	:	910-615-3999
Fax Number	:	910-615-9777

Authorized Official
Title or Position	:	VP REVENUE CYCLE AND MANAGED CARE
Name	:	JOSEPH BARTON FISER
Credential	:
Telephone Number	:	910-615-5572

Provider Enumeration Date	:	11/15/2024
Last Update Date	:	04/08/2026

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