Advance Family And Sports Medicine Center, Pllc - Medicare Primary Care in Advance, NC

Advance Family And Sports Medicine Center, Pllc is a medicare enrolled primary clinic (Family Medicine) in Advance, North Carolina. The current practice location for Advance Family And Sports Medicine Center, Pllc is 169 Yadkin Valley Rd, Suite 101, Advance, North Carolina. For appointments, you can reach them via phone at (336) 940-2659. The mailing address for Advance Family And Sports Medicine Center, Pllc is 169 Yadkin Valley Rd, Suite 101, Advance, North Carolina and phone number is (336) 940-2659.

Advance Family And Sports Medicine Center, Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1376854083. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (336) 940-2659.

Contact Information

Advance Family And Sports Medicine Center, Pllc
169 Yadkin Valley Rd
Suite 101
Advance
NC 27006-8786
(336) 940-2659
Not Available

Primary Care Clinic Profile

Full NameAdvance Family And Sports Medicine Center, Pllc
SpecialityFamily Medicine
Location169 Yadkin Valley Rd, Advance, North Carolina
Authorized Official Name and PositionWalter Ezeigbo (OWNER/CEO)
Authorized Official Contact3369402659
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Advance Family And Sports Medicine Center, Pllc
169 Yadkin Valley Rd
Suite 101
Advance
NC 27006-8786

Ph: (336) 940-2659
Advance Family And Sports Medicine Center, Pllc
169 Yadkin Valley Rd
Suite 101
Advance
NC 27006-8786

Ph: (336) 940-2659

NPI Details:

NPI Number1376854083
Provider Enumeration Date06/28/2010
Last Update Date11/05/2010

Medicare PECOS Information:

Medicare PECOS PAC ID9537351440
Medicare Enrollment IDO20101011000997

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Medical Identifiers

Medical identifiers for Advance Family And Sports Medicine Center, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376854083NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
207QS0010XFamily Medicine - Sports Medicine (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Advance Family And Sports Medicine Center, Pllc acts as a billing entity for following providers:
Provider NameWalter A Ezeigbo
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1306839659
PECOS PAC ID: 1052482379
Enrollment ID: I20080613000474

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