Organization
FIRST CARE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENEDICT ONWUKWE OKWARA (MEDICAL DIRECTOR)
(704) 291-9267
Entity
Organization
Contact information
Practice address
1462 CONSTITUTION BLVD, ROCK HILL, SC 29732-3075
(704) 291-9267
(704) 283-7939
Mailing address
404 S SUTHERLAND AVE, MONROE, NC 28112-5060
(704) 291-9267
(704) 283-7939
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025A7
BCBS OF NC
NC
01
—
2326436
GROUP MEDICARE #
NC
05
—
5917848
—
NC
05
—
GP5781
—
SC
Enumeration date
06/15/2011
Last updated
09/07/2012
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