Provider Demographics
NPI:1487618344
Name:MID CAROLINA PRIMARY CARE, PA
Entity type:Organization
Organization Name:MID CAROLINA PRIMARY CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT OF COMPANY
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:FINLAY-TOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-777-2704
Mailing Address - Street 1:709C WICKER ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4142
Mailing Address - Country:US
Mailing Address - Phone:919-777-2704
Mailing Address - Fax:919-777-2752
Practice Address - Street 1:709C WICKER ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4142
Practice Address - Country:US
Practice Address - Phone:919-777-2704
Practice Address - Fax:919-777-2752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty