Provider Demographics
NPI:1477444255
Name:CHILDREN'S URGENT CARE OF FAYETTEVILLE, PLLC
Entity type:Organization
Organization Name:CHILDREN'S URGENT CARE OF FAYETTEVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WAREES
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAREES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-413-9657
Mailing Address - Street 1:5175 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-4578
Mailing Address - Country:US
Mailing Address - Phone:901-413-9657
Mailing Address - Fax:472-215-8665
Practice Address - Street 1:4118 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3360
Practice Address - Country:US
Practice Address - Phone:901-413-9657
Practice Address - Fax:472-215-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency MedicineGroup - Single Specialty