Organization
CAPE FEAR VALLEY HEALTH SYSTEM SPECIALTY GROUP, LLC
Active
Other names
CAPE FEAR VALLEY HEALTH-THE CLINIC AT WALMART
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL NAGOWSKI (CEO)
(910) 615-6700
Entity
Organization
Contact information
Practice address
4545 FAYETTEVILLE ROAD, RAEFORD, NC 28376
(910) 615-3100
(910) 486-2154
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 615-6448
(910) 615-5070
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
H0213
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
07/15/2010
Last updated
07/15/2010
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