Organization
MCPC-5, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY FOSTER (CEO)
(910) 715-4473
Entity
Organization
Contact information
Practice address
812 CANDY PARK RD, PEMBROKE, NC 28372-9120
(910) 417-4105
(910) 417-4120
Mailing address
PO BOX 896208, CHARLOTTE, NC 28289-6208
(910) 417-4105
(910) 417-4120
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
07/10/2014
Last updated
12/09/2024
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