Organization
FUQUAY-VARINA FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE PAGE MATTHEWS (OFFICE MANAGER)
(919) 552-2292
Entity
Organization
Contact information
Practice address
431 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2374
(919) 552-2292
Mailing address
431 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2374
(919) 552-2292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
87983
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
790231C
—
NC
Enumeration date
12/19/2005
Last updated
08/19/2010
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