Healthcare Provider Details

I. General information

NPI: 1609405125
Provider Name (Legal Business Name): EMMA YORK VOMER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3904 OLEANDER DR
WILMINGTON NC
28403-6717
US

IV. Provider business mailing address

4705 UNIVERSITY DR BLDG 700
DURHAM NC
27707-3489
US

V. Phone/Fax

Practice location:
  • Phone: 910-530-1874
  • Fax:
Mailing address:
  • Phone: 910-530-1874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number202402405
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: