Healthcare Provider Details

I. General information

NPI: 1871547422
Provider Name (Legal Business Name): MEDICAL SERVICES OF THE ALBEMARLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4923 S CROATAN HWY
NAGS HEAD NC
27959-9709
US

IV. Provider business mailing address

1134 N ROAD ST BLDG.9
ELIZABETH CITY NC
27909-3365
US

V. Phone/Fax

Practice location:
  • Phone: 252-261-8040
  • Fax: 252-441-7041
Mailing address:
  • Phone: 252-338-9451
  • Fax: 252-338-9170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY L WHITE
Title or Position: PRESIDENT
Credential: MD
Phone: 252-338-9451