Southeastern Medical, PA
Physical Medicine & Rehabilitation, Pain Medicine in Sunset Beach, NC. Organization (NPI-2).
NPI number1467006197
StatusActive
Last updated in NPPESJul 31, 2019
Details
- NPI
- 1467006197
- Entity type
- Organization (NPI-2)
- Legal business name
- Southeastern Medical, PA
- Organization subpart
- No
- Enumeration date
- Jul 31, 2019
- Last updated
- Jul 31, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | – | – | Yes |
Practice location
830 Sunset Blvd NSunset Beach, NC 28468-4262
Phone 910-575-5750
Mailing address
830 Sunset Blvd NSunset Beach, NC 28468-4262
Phone 910-575-5750
Authorized official
Alicia Berry
Insurance Supervisor
9102877001
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