Organization
CLEMMONS URGENT AND PRIMARY CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARIE MANTIN M.D. (OWNER/ ONLY PROVIDER)
(336) 712-8225
Entity
Organization
Contact information
Practice address
2245 LEWISVILLE CLEMMONS RD STE C, CLEMMONS, NC 27012-7461
(336) 712-8225
(336) 712-8227
Mailing address
2245 LEWISVILLE CLEMMONS RD STE C, CLEMMONS, NC 27012-7461
(336) 712-8225
(336) 712-8227
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200000535
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2288835C
MEDICARE
NC
01
—
2335641
MEDICARE
NC
05
—
89136M4
—
NC
Enumeration date
12/27/2007
Last updated
07/11/2013
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