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Organization

FIRST CARE MEDICAL CLINIC

Active
Other names
FIRST CARE MEDICAL CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
BENEDICT O OKWARA MD (MEDICAL DIRECTOR)
(704) 291-9267
Entity
Organization

Contact information

Practice address
1426 E MAIN ST, ALBEMARLE, NC 28001-5236
(704) 982-0950
Mailing address
404 S SUTHERLAND AVE, MONROE, NC 28112-5060
(704) 982-0950

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
207Q00000X
Family Medicine Physician
207QA0000X
Adolescent Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
Primary
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
208000000X
Pediatrics Physician
2080A0000X
Pediatric Adolescent Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012HW
BCBSNC
NC
01
2326436
MEDICARE GROUP #
NC
05
89012HW
NC
01
QPA311
SOUTHCAROLINA MEDICAID
SC
Enumeration date
03/21/2007
Last updated
04/13/2010
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