Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PURA CLINIC FAMILY MEDICINE PC
Active
Organization
PURA CLINIC FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMAD A SHAKIR MD (OWNER/MD)
(910) 829-0143
Entity
Organization
Contact information
Practice address
124 BAYWOOD RD, SUITE 111, FAYETTEVILLE, NC 28312-9136
(910) 829-0143
(910) 829-5107
Mailing address
124 BAYWOOD RD, SUITE 111, FAYETTEVILLE, NC 28312-9136
(910) 829-0143
(910) 829-5107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487077491
—
NC
01
—
148J4
BCBSNC
NC
Enumeration date
01/27/2014
Last updated
11/10/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up