Healthcare Provider Details

I. General information

NPI: 1467571679
Provider Name (Legal Business Name): WRIGHTSVILLE BEACH FAMILY MEDICINE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 ALLENS LANE SUITE 100
WILMINGTON NC
28403
US

IV. Provider business mailing address

1721 ALLENS LANE SUITE 100
WILMINGTON NC
28403
US

V. Phone/Fax

Practice location:
  • Phone: 910-344-8900
  • Fax: 910-344-8902
Mailing address:
  • Phone: 910-344-8900
  • Fax: 910-344-8902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER KRAMER
Title or Position: PRESIDENT
Credential: DO
Phone: 910-344-8900