NPI 1306120795 · live from the CMS NPI Registry
Advance Rehabilitation And Nursing
Family Medicine in Advance, NC. National Provider Identifier 1306120795, active.
NPI record
| NPI | 1306120795 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 169 Yadkin Valley Rd, Suite 101, Advance, NC 27006 |
| Practice phone | 336-940-2659 |
| Mailing address | 5515 Fresh Field Ln, Winston Salem, NC 27106 |
| Enumerated | October 4, 2011 |
| Last updated | October 4, 2011 |
| Authorized official | Walter Ezeigbo, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 9601605 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.