Organization
FIRST CARE MEDICAL CLINIC
Active
Other names
FIRST CARE MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
BENEDICT O OKWARA MD (MEDICAL DIRECTOR)
(704) 888-6156
Entity
Organization
Contact information
Practice address
210 WEST MAIN STREET, LOCUST, NC 28097
(704) 888-6156
Mailing address
404 S SUTHERLAND AVE, MONROE, NC 28112-5060
(704) 888-6156
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0259H
BCBSNC
NC
01
—
2326436
GROUP MEDICARE #
NC
05
—
890259H
—
NC
Enumeration date
03/21/2007
Last updated
04/13/2010
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