Healthcare Provider Details

I. General information

NPI: 1508508185
Provider Name (Legal Business Name): LILLIE SNOW HERLIHY CAMPBELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 CURRITUCK DR STE 100
WILMINGTON NC
28403-1155
US

IV. Provider business mailing address

PO BOX 936857
ATLANTA GA
31193-6857
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-6000
  • Fax: 910-550-3787
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL90006
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2026-03426
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: