Organization
SISTASIS FAMILY PRACTICE,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROWENA SISTASIS MD (VICE PRESIDENT)
(336) 633-1212
Entity
Organization
Contact information
Practice address
147 E ACADEMY ST, ASHEBORO, NC 27203-5706
(336) 633-1212
(336) 633-1218
Mailing address
PO BOX 4247, ASHEBORO, NC 27204-4247
(336) 633-1212
(336) 633-1218
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016FU
BCBS GROUP NO.
NC
05
—
89016FU
—
NC
Enumeration date
03/29/2006
Last updated
08/05/2010
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