Organization
FAITH PEDIATRICS AND ADOLESCENT MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNELL COVINGTON MD (PHYSICIAN)
(919) 881-9440
Entity
Organization
Contact information
Practice address
3350 SIX FORKS RD, RALEIGH, NC 27609-7233
(919) 881-9440
(919) 881-9465
Mailing address
3350 SIX FORKS RD, RALEIGH, NC 27609-7233
(919) 881-9440
(919) 881-9465
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01770
BLUE CROSS BLUE SHIELD
NC
05
—
7901770
—
NC
Enumeration date
03/17/2006
Last updated
04/13/2021
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