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Organization
FASTMED PC
Active
Organization
FASTMED PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NENA REEVES (DIRECTOR OF BUSINESS DEVELOPMENT)
(919) 550-0821
Entity
Organization
Contact information
Practice address
2001 S. MAIN ST, WAKE FOREST, NC 27587
(919) 562-3155
(919) 562-7401
Mailing address
935 SHOTWELL RD, SUITE 108, CLAYTON, NC 27520
(919) 562-3155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017H1
BCBS
NC
05
—
5902449
—
NC
01
—
7181794
AETNA
—
Enumeration date
01/08/2007
Last updated
08/19/2010
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