Provider Demographics
NPI:1689638025
Name:WAYNE FAMILY MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:WAYNE FAMILY MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ASHRAF
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-734-3999
Mailing Address - Street 1:2807 MCLAMB PL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1647
Mailing Address - Country:US
Mailing Address - Phone:919-734-3999
Mailing Address - Fax:919-734-0107
Practice Address - Street 1:2807 MCLAMB PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1647
Practice Address - Country:US
Practice Address - Phone:919-734-3999
Practice Address - Fax:919-734-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890248WMedicaid
NC2339681OtherBCBS
DE5383OtherRAILROAD MEDICARE
2339681OtherMEDICARE
NC890248WMedicaid