Provider Demographics
NPI:1972667368
Name:CAPE FEAR PULMONARY ASSOCIATES,P.A.
Entity Type:Organization
Organization Name:CAPE FEAR PULMONARY ASSOCIATES,P.A.
Other - Org Name:JAYESH B DAVE,M.D.,P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-323-4733
Mailing Address - Street 1:1201 WALTER REED RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4437
Mailing Address - Country:US
Mailing Address - Phone:910-323-4733
Mailing Address - Fax:910-323-2097
Practice Address - Street 1:1201 WALTER REED RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4437
Practice Address - Country:US
Practice Address - Phone:910-323-4733
Practice Address - Fax:910-323-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01715OtherBLUE CROSS GROUP #
NC8901715Medicaid
NC2344497Medicare ID - Type UnspecifiedMEDICARE GROUP #