Healthcare Provider Details

I. General information

NPI: 1871422055
Provider Name (Legal Business Name): RAWAN ABUMOHSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 MILITARY CUTOFF RD
WILMINGTON NC
28403-5744
US

IV. Provider business mailing address

1613 MILITARY CUTOFF RD
WILMINGTON NC
28403-5744
US

V. Phone/Fax

Practice location:
  • Phone: 910-256-6364
  • Fax:
Mailing address:
  • Phone: 910-256-6364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number2903
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: