MEDICARE: FASTMED PRIMARY CARE, P.C.

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

General Provider Information

NPI Number	:	1912774423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FASTMED PRIMARY CARE, P.C.

Provider Business Mailing Address
First Line	:	4613 UNIVERSITY DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3458
Country	:	US
Telephone Number	:	919-329-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 FRANCAM DR STE 120
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-4500
Country	:	US
Telephone Number	:	910-487-1100
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JIM MOFFETT
Credential	:
Telephone Number	:	919-550-0821

Provider Enumeration Date	:	12/05/2023
Last Update Date	:	07/09/2025

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