1053074369 NPI number — MCPC-22 LLC DBA FIRSTHEALTH SANDHILLS NEUROLOGISTS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053074369 NPI number — MCPC-22 LLC DBA FIRSTHEALTH SANDHILLS NEUROLOGISTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCPC-22 LLC DBA FIRSTHEALTH SANDHILLS NEUROLOGISTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053074369
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 PAGE ROAD N
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
PINEHURST
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28374-8748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-375-7344
Provider Business Mailing Address Fax Number:
910-235-0546

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 PAGE ROAD N
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
PINEHURST
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28374-8748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-375-7344
Provider Business Practice Location Address Fax Number:
910-235-0546
Provider Enumeration Date:
10/14/2021

Additional Information

Authorized Official

Authorized Official Last Name:
FOSTER
Authorized Official First Name:
MICKEY
Authorized Official Middle Name:
WHELESS
Authorized Official Title or Position:
CEO-FIRSTHEALTH OF THE CAROLINAS
Authorized Official Telephone Number:
910-715-1000

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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