Healthcare Provider Details

I. General information

NPI: 1467952564
Provider Name (Legal Business Name): MICHAEL RICHARD PINTO FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 PHYSICIANS DR
WILMINGTON NC
28401-7335
US

IV. Provider business mailing address

1414 PHYSICIANS DR
WILMINGTON NC
28401-7335
US

V. Phone/Fax

Practice location:
  • Phone: 800-733-1476
  • Fax:
Mailing address:
  • Phone: 800-733-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010298
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: