Healthcare Provider Details

I. General information

NPI: 1427281070
Provider Name (Legal Business Name): VERDIN PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9869 OCEAN HWY W STE 12
CALABASH NC
28467-2636
US

IV. Provider business mailing address

9869 OCEAN HWY W STE 12
CALABASH NC
28467-2636
US

V. Phone/Fax

Practice location:
  • Phone: 910-575-3522
  • Fax: 910-575-3580
Mailing address:
  • Phone: 910-575-3522
  • Fax: 910-575-3580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. THOMAS M VERDIN III
Title or Position: OWNER
Credential: MD
Phone: 910-575-3522