Organization
FIRST CARE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENEDICT O OKWARA MD (MEDICAL DIRECTOR)
(704) 291-9267
Entity
Organization
Contact information
Practice address
7884 IDLEWILD ROAD, INDIANTRAIL, NC 28079
(704) 291-9267
(704) 291-7413
Mailing address
404 S SUTHERLAND AVE, MONROE, NC 28112-5060
(704) 291-9267
(704) 225-0428
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E85143
NC
208000000X
Pediatrics Physician
E85143
NC
2080A0000X
Pediatric Adolescent Medicine Physician
E85143
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2326436
MEDICARE GROUP #
NC
Enumeration date
05/04/2007
Last updated
04/14/2010
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