Organization
CAROLINA FAMILY MEDICINE & URGENT CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CODEY JEAN BROWN (OFFICE MANAGER/DELEGATED OFFICIAL)
(704) 871-9731
Entity
Organization
Contact information
Practice address
1503 E BROAD ST, STATESVILLE, NC 28625-4301
(704) 871-9731
(704) 871-1105
Mailing address
1503 E BROAD ST, STATESVILLE, NC 28625-4301
(704) 871-9731
(704) 871-1105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200001772371
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014W8
BCBSNC
NC
05
—
89014W8
—
NC
Enumeration date
05/22/2007
Last updated
06/26/2012
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