MEDICARE: ONSLOW AMBULATORY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	2007-01406	NC

General Provider Information

NPI Number	:	1033306279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONSLOW AMBULATORY SERVICES, INC.

Provider Business Mailing Address
First Line	:	200 MEMORIAL DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6332
Country	:	US
Telephone Number	:	910-577-4703
Fax Number	:	910-577-2575

Provider Business Practice Location Address
First Line	:	215B STATION ST
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6304
Country	:	US
Telephone Number	:	910-577-2334
Fax Number	:	910-577-2363

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	CARL BIBER
Credential	:
Telephone Number	:	910-577-2969

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	04/07/2025

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