Organization
SANFORD MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROWLAND MANGUM M.D. (PRESIDENT)
(919) 774-6518
Entity
Organization
Contact information
Practice address
555 CARTHAGE ST, SANFORD, NC 27330-4104
(919) 774-6518
(919) 774-1831
Mailing address
555 CARTHAGE ST, SANFORD, NC 27330-4104
(919) 774-6518
(919) 774-1831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02610
BCBS GROUP PROVIDER NUMBE
NC
05
—
8902610
—
NC
Enumeration date
05/27/2006
Last updated
09/11/2025
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