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Organization

FAMHEALTH PRIMARY CARE , PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ENID MATOS TALLMER PA-C (PRESIDENT)
(919) 697-5388
Entity
Organization

Contact information

Practice address
5720 CREEDMOOR RD, RALEIGH, NC 27612-2256
(919) 782-0430
Mailing address
5720 CREEDMOOR RD, RALEIGH, NC 27612-2256
(919) 782-0430

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
C2016204005421
NC

Other

Enumeration date
08/06/2016
Last updated
08/06/2016
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