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Organization
PRIMARY CARE OF ST. PAULS, LLC
Active
Organization
PRIMARY CARE OF ST. PAULS, LLC
Active
Parent organization
PRIMARY CARE OF ST. PAULS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMARY CARE OF ST. PAULS, LLC
Authorized official
MOHAMED B OSMAN M.D. (OWNER)
(910) 865-5177
Entity
Organization
Contact information
Practice address
122 EAST BLUE STREET, ST. PAULS, NC 28384
(910) 865-5177
(910) 865-9400
Mailing address
P O BOX 9940, FAYETTEVILLE, NC 28311-9940
(910) 865-5177
(910) 865-9400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2002-01142
NC
207Q00000X
Family Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900350
—
NC
Enumeration date
09/06/2007
Last updated
08/09/2012
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