Organization
FAYETTEVILLE GASTROENTEROLOGY ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F VORDER BRUEGGE MD (OWNER)
(910) 323-5203
Entity
Organization
Contact information
Practice address
2041 VALLEYGATE DR, FAYETTEVILLE, NC 28304-3688
(910) 323-5203
(910) 323-3650
Mailing address
2041 VALLEYGATE DR, FAYETTEVILLE, NC 28304-3688
(910) 323-5203
(910) 323-3650
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AS0071
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191J
BCBS
—
05
—
890191J
—
NC
Enumeration date
07/29/2006
Last updated
04/14/2021
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