# CAPE FEAR VALLEY HEALTH SYSTEM SPECIALTY GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CONVENIENT CARE FOR HOKE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356665152
- **Authorized official:** MR. MICHAEL NAGOWSKI (CEO)
- **Authorized official phone:** (910) 615-6700

## Contact information

- **Practice address:** 104 W SOUTHERN AVE, RAEFORD, NC 28376-3218
- **Practice address phone:** (910) 615-3140
- **Practice address fax:** (910) 486-2169
- **Mailing address:** PO BOX 40908, FAYETTEVILLE, NC 28309-0908
- **Mailing address phone:** (910) 615-6448
- **Mailing address fax:** (910) 615-5070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | H0213 | NC | Yes |

## Other

- **Enumeration date:** 03/23/2010
- **Last updated:** 07/14/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5913981 | — | NC |