Healthcare Provider Details
I. General information
NPI: 1811094345
Provider Name (Legal Business Name): HEALTH SCIENCES FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2131 S 17TH ST
WILMINGTON NC
28401-7407
US
IV. Provider business mailing address
2131 S 17TH ST
WILMINGTON NC
28401-7407
US
V. Phone/Fax
- Phone: 910-772-9202
- Fax: 910-772-9452
- Phone: 910-772-9202
- Fax: 910-772-9452
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
L
HARDYMAN
Title or Position: MANAGER
Credential:
Phone: 910-772-9202