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CLAYTON INTERNAL MEDICINE PC NPI 1366658833


NPI Information

NPI: 1366658833
Provider Name: CLAYTON INTERNAL MEDICINE PC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 34D1005814

Address:
301 AMOS ST
CLAYTON, NC
ZIP 27520
Phone: (919) 550-6336
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CLAYTON INTERNAL MEDICINE PC is a medical specialty clinic center in Clayton, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). CLAYTON INTERNAL MEDICINE PC NPI is 1366658833. The provider is registered as an organization entity type.

The provider's business location address is:

301 AMOS ST
CLAYTON, NC
ZIP 27520-644
Phone: (919) 550-6336
Fax: (919) 550-0180

The provider's authorized official is Mazen Khusayem .
The authorized official title is President and has the following contact phone number (919) 550-6336.

The CLIA number assigned to this NPI record is 34D1005814 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 1/22/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical Specialty9900898NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G10034MEDICARE UPINNORTH CAROLINA
22280894MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
389126XVMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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