Provider Demographics
NPI:1508878257
Name:HOPEWELL FAMILY MEDICINE PA
Entity Type:Organization
Organization Name:HOPEWELL FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-430-9004
Mailing Address - Street 1:304 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3578
Mailing Address - Country:US
Mailing Address - Phone:828-430-9004
Mailing Address - Fax:828-430-9444
Practice Address - Street 1:304 S GREEN ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3578
Practice Address - Country:US
Practice Address - Phone:828-430-9004
Practice Address - Fax:828-430-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8957849Medicaid
57849OtherBCBS
NC8957849Medicaid