Organization
PINEHURST MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON ENFINGER (CEO)
(910) 235-3004
Entity
Organization
Contact information
Practice address
205 PAGE RD, PINEHURST, NC 28374-8798
(910) 295-5511
(910) 235-3443
Mailing address
200 PAVILION WAY, SOUTHERN PINES, NC 28387-4561
(910) 295-5511
(910) 235-2690
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
39578
NC
207R00000X
Internal Medicine Physician
Primary
39578
NC
207RC0000X
Cardiovascular Disease Physician
39578
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
39578
NC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
39578
NC
207RG0100X
Gastroenterology Physician
39578
NC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
39578
NC
207RH0003X
Hematology & Oncology Physician
39578
NC
207RI0011X
Interventional Cardiology Physician
39578
NC
207RP1001X
Pulmonary Disease Physician
39578
NC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
39578
NC
208000000X
Pediatrics Physician
39578
NC
261QM1300X
Multi-Specialty Clinic/Center
39578
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02418
BC/BS NC GROUP #
NC
01
—
0395360001
DME-PALMETTO GROUP#
NC
05
—
8902418
—
NC
01
—
CC6114
PALMETTO GBA GROUP#
NC
01
—
NPA775
SC MEDICAID GROUP#
SC
Enumeration date
05/27/2006
Last updated
02/16/2023
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