Provider Demographics
NPI:1548328560
Name:CAPE FEAR PSYCHOLOGICAL & PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:CAPE FEAR PSYCHOLOGICAL & PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SAVARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-763-8134
Mailing Address - Street 1:1121 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7304
Mailing Address - Country:US
Mailing Address - Phone:910-763-8134
Mailing Address - Fax:910-763-3311
Practice Address - Street 1:1121 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7304
Practice Address - Country:US
Practice Address - Phone:910-763-8134
Practice Address - Fax:910-763-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0195KOtherBLUE CROSS BLUE SHIELD
NC1682Medicare ID - Type Unspecified