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Organization

HAMLET MEDICAL CLINIC.P.A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BHARATKUMAR NATVERLAL THAKKAR M.D. (PRESIDENT)
(910) 920-1579
Entity
Organization

Contact information

Practice address
400 KIMBERWICKE DR, FAYETTEVILLE, NC 28311-7177
(910) 920-1579
Mailing address
400 KIMBERWICKE DR, FAYETTEVILLE, NC 28311-7177
(910) 920-1579

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9500248
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110229797
RAILROAD MEDICARE
NC
05
7982447
NC
01
82447
BLUE CROSS BLUE SHIELD
NC
Enumeration date
04/15/2007
Last updated
03/07/2023
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