Organization
FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE BRIAN OUTEN M.D. (PHYSICIAN)
(704) 624-3790
Entity
Organization
Contact information
Practice address
2820 BELK MILL RD, WINGATE, NC 28174-8764
(704) 624-3790
(704) 624-3578
Mailing address
303 WEST MAIN STREET, MARSHVILLE, NC 28103-0648
(704) 624-3790
(704) 624-3578
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
9900973
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891293G
—
NC
Enumeration date
03/21/2007
Last updated
06/24/2009
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