Organization
HEMATOLOGY & ONCOLOGY ASSOCIATES OF FAYETTEVILLE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL MANUBHAI BAKRI M.D. (PRESIDENT)
(910) 615-6914
Entity
Organization
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-6910
(910) 615-5219
Mailing address
PO BOX 42935, FAYETTEVILLE, NC 28309-2935
(910) 615-6910
(910) 615-5219
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
9900923
NC
207RX0202X
Medical Oncology Physician
26183
NC
207RX0202X
Medical Oncology Physician
32779
NC
363LF0000X
Family Nurse Practitioner
200943
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890239Q
—
NC
Enumeration date
04/12/2006
Last updated
10/27/2011
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