Organization
SANDHILLS NEPHROLOGY AND INTERNAL MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILDRED ENID ROMEU (OFFICE MANAGER)
(910) 323-1671
Entity
Organization
Contact information
Practice address
1218 WALTER REED RD, FAYETTEVILLE, NC 28304-4440
(910) 323-1671
(910) 323-9656
Mailing address
1218 WALTER REED RD, FAYETTEVILLE, NC 28304-4440
(910) 323-1671
(910) 323-9656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197C
BLUE CROSS/BLUE SHIELD
NC
05
—
790197C
—
NC
Enumeration date
10/17/2006
Last updated
09/30/2008
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