Organization
CAROLINA FAMILY MEDICINE & WELLNESS
Active
Other names
CFMW, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSANDRO R CASTILLO M.D. (MEDICAL DIRECTOR)
(704) 662-3627
Entity
Organization
Contact information
Practice address
478 WILLIAMSON RD., SUITE B, MOORESVILLE, NC 27117-9109
(704) 662-3627
(704) 662-3229
Mailing address
478 WILLIAMSON RD., SUITE B, MOORESVILLE, NC 27117-9109
(704) 662-3627
(704) 662-3229
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
9900793
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015VY
BLUE CROSS/BLUE SHIELD
NC
05
—
89015VY
—
NC
Enumeration date
04/04/2006
Last updated
08/22/2020
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