Wayne Health Medical Clinic, Llc

NPI 1558630699 - Internal Medicine - 207RE0101X

NPI Details
NPI 1558630699
Enumeration Date 12/19/2011
Last Updated 12/10/2015
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name CLYDE LOUIS CLYDE
Position EXECUTIVE DIRECTOR
Phone (919) 587-4081
Fax (919) 587-0775
Practice Location
208 COX BLVD
SUITE 102
GOLDSBORO NC, 27534-9414, US
Phone (919) 587-4081
Fax (919) 587-0775
Business Location
PO BOX 1717
GOLDSBORO NC, 27533-1717, US
Phone (919) 587-4081
Fax (919) 739-6966
Toxanomy
Taxonomy Code 207RE0101X
License State
License Number
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According to our database, Wayne Health Medical Clinic, Llc NPI is 1558630699, taxonomy code is 207RE0101X Wayne Health Medical Clinic, Llc physically located at 208 Cox Blvd, Goldsboro NC, 27534-9414. NPI Number 1033115704 has the healthcare provider type.

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1558630699 NPI number is provided on an as is basis without warranty of any kind. 1558630699 is maintained by the National Plan & Provider Enumeration System. The contents of Wayne Health Medical Clinic, Llc are for informational purposes only.