Provider Demographics
NPI:1255372652
Name:URGENT MEDICAL AND FAMILY CARE, PA
Entity type:Organization
Organization Name:URGENT MEDICAL AND FAMILY CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-299-0000
Mailing Address - Street 1:102 POMONA DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1616
Mailing Address - Country:US
Mailing Address - Phone:336-299-0000
Mailing Address - Fax:336-299-2335
Practice Address - Street 1:102 POMONA DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1616
Practice Address - Country:US
Practice Address - Phone:336-299-0000
Practice Address - Fax:336-299-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02830OtherBLUE CROSS BLUE SHIELD
NC6902830Medicaid
NC0578930001Medicare NSC
NC02830OtherBLUE CROSS BLUE SHIELD