Azalea Primary Care
Physician Assistant in Wilmington, NC. Organization (NPI-2).
NPI number1164528709
StatusActive
Last updated in NPPESJul 22, 2013
Details
- NPI
- 1164528709
- Entity type
- Organization (NPI-2)
- Legal business name
- Azalea Primary Care
- Organization subpart
- No
- Enumeration date
- Sep 14, 2006
- Last updated
- Jul 22, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 103239 | NC | Yes |
Practice location
422 Stradleigh RdWilmington, NC 28403-1232
Phone 910-297-0137
Mailing address
422 Stradleigh RdWilmington, NC 28403-1232
Phone 910-297-0137
Authorized official
Tammy S Melgar
Owner
9102970137
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