Harvardmed Family Practice, Inc

Organization Active NPI Family Medicine Physician · Angier, NC

NPI 1295914307 · NPPES record last updated Jun 6, 2008

Key facts

NPI
1295914307
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
200101219 (NC)
Legal business name
HARVARDMED FAMILY PRACTICE, INC
Practice address
728 N Raleigh St
Angier, NC 27501-9134
Phone
(919) 639-0100
Fax
(919) 639-0313
NPI assigned
Oct 25, 2007
Organization subpart
No

Authorized official

Name
Dr. Mariyam A Hussain, M.D.
Title
Owner
Phone
(919) 639-0100

National Provider Directory

Locations

728 N Raleigh St
Angier, NC 27501
Phone (919) 639-0100

2136 N Main St
Fuquay Varina, NC 27526
Phone (919) 567-1607

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 200101219 NC Yes

Addresses

Primary practice location

728 N Raleigh St
Angier, NC 27501-9134

Mailing address

PO Box 1110
Angier, NC 27501-1110
Phone (919) 639-0100

Other identifiers

IdentifierTypeStateIssuer
1291WOtherNCBCBS PROVIDER #
891291WMedicaidNC

Other providers in Angier, NC

All providers in Angier, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.