NPI 1376854083 · live from the CMS NPI Registry
Advance Family And Sports Medicine Center, PLLC
Family Medicine in Advance, NC. National Provider Identifier 1376854083, active.
NPI record
| NPI | 1376854083 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 |
| Enumerated | June 28, 2010 |
| Last updated | November 5, 2010 |
| Authorized official | Walter Ezeigbo, Owner/Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine, Sports Medicine | 207QS0010X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.