Individual
DR. ISSA ELGENDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1262 OLIVER ST, STE B, FAYETTEVILLE, NC 28304-4449
(910) 609-4801
(910) 609-5406
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 609-6448
(910) 609-7040
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200000049
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891239J
—
NC
Enumeration date
05/24/2005
Last updated
07/09/2007
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