Organization
FASTMED HEALTH NC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY J STAYMATES (NATIONAL CREDENTIALING MMANAGER)
(480) 500-2285
Entity
Organization
Contact information
Practice address
935 SHOTWELL RD STE 108, CLAYTON, NC 27520-5598
(919) 359-2667
(919) 882-9502
Mailing address
935 SHOTWELL RD STE 108, CLAYTON, NC 27520-5598
(919) 359-2667
(919) 882-9502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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