Organization
PRIME PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEDHAVINI H DHANDHA MD (PRESIDENT)
(910) 437-9600
Entity
Organization
Contact information
Practice address
3415B MELROSE ROAD, FAYETTEVILLE, NC 28304
(910) 437-9600
(910) 437-9801
Mailing address
PO BOX 25756, FAYETTEVILLE, NC 28314-5012
(910) 437-9600
(910) 437-9801
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9401399
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7928785
—
NC
Enumeration date
01/30/2006
Last updated
08/22/2020
Update your record
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