OrganizationActive
Independence Medical, PA
NPI 1700845112 · Geriatric Medicine (Family Medicine) Physician · Smithfield, NC
Provider details
- NPI number
- 1700845112
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Bernard Bennett, President
- License
- 36493 (NC)
Practice location
515 Barbour Rd
Smithfield, NC 27577-7698
Phone: (919) 544-4747
Fax: (919) 544-0104
Mailing address
1209 Falls Bridge Dr
Raleigh, NC 27614-8935
Registry dates
- Enumerated
- 2006-03-23
- Last updated
- 2013-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.