# FASTMED PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073661690
- **Authorized official:** NENA REEVES (DIRECTOR OF BUSINESS DEVELOPMENT)
- **Authorized official phone:** (919) 550-0821

## Contact information

- **Practice address:** 2001 S. MAIN ST, WAKE FOREST, NC 27587
- **Practice address phone:** (919) 562-3155
- **Practice address fax:** (919) 562-7401
- **Mailing address:** 935 SHOTWELL RD, SUITE 108, CLAYTON, NC 27520
- **Mailing address phone:** (919) 562-3155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 08/19/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 017H1 | BCBS | NC |
| 05 | — | 5902449 | — | NC |
| 01 | — | 7181794 | AETNA | — |