Healthcare Provider Details

I. General information

NPI: 1619988607
Provider Name (Legal Business Name): BOTROS & POLLOCK, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 DOCTORS CIR
WILMINGTON NC
28401-7405
US

IV. Provider business mailing address

1625 DOCTORS CIR
WILMINGTON NC
28401-7405
US

V. Phone/Fax

Practice location:
  • Phone: 910-762-0234
  • Fax: 910-762-7042
Mailing address:
  • Phone: 910-762-0234
  • Fax: 910-762-7042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERIF B BOTROS
Title or Position: VICE-PRESIDENT
Credential: MD
Phone: 910-762-0234