Basic Information
Provider Information
NPI: 1447928957
EntityType: 2
ReplacementNPI:  
OrganizationName: A PLUS FAMILY CARE CENTER, INC
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Mailing Information
Address1: PO BOX 10492
Address2:  
City: RALEIGH
State: NC
PostalCode: 276050492
CountryCode: US
TelephoneNumber: 9196547309
FaxNumber: 9196511045
Practice Location
Address1: 4551 NEW BERN AVE STE 160
Address2:  
City: RALEIGH
State: NC
PostalCode: 276101552
CountryCode: US
TelephoneNumber: 9195561008
FaxNumber: 9195566099
Other Information
ProviderEnumerationDate: 08/31/2021
LastUpdateDate: 08/31/2021
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AuthorizedOfficialLastName: MIMS
AuthorizedOfficialFirstName: WANETT
AuthorizedOfficialMiddleName: T
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9196547309
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 08/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 
208000000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPediatrics 
207Q00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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