Healthcare Provider Details

I. General information

NPI: 1124609516
Provider Name (Legal Business Name): DUNIA LAITH ANWAR-PEALSTROM DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 AVON ST
FAYETTEVILLE NC
28304-4423
US

IV. Provider business mailing address

1307 AVON ST
FAYETTEVILLE NC
28304-4423
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-1718
  • Fax:
Mailing address:
  • Phone: 910-323-1718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2023-01886
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: