Healthcare Provider Details

I. General information

NPI: 1427010081
Provider Name (Legal Business Name): CAROLINA ARTHRITIS ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 S 17TH ST
WILMINGTON NC
28401-6442
US

IV. Provider business mailing address

P O BOX 63232
CHARLOTTE NC
28263-3232
US

V. Phone/Fax

Practice location:
  • Phone: 910-762-1182
  • Fax: 910-762-1291
Mailing address:
  • Phone: 910-762-1182
  • Fax: 910-762-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN T WALTERS
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 910-762-1182