Healthcare Provider Details

I. General information

NPI: 1831519404
Provider Name (Legal Business Name): JOHN ALEXANDER MIHALTSES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EASTERN NEPHROLOGY ASSOCIATES, PLLC 1302 MEDICAL CENTER DRIVE
WILMINGTON NC
28401
US

IV. Provider business mailing address

1302 MEDICAL CENTER DR
WILMINGTON NC
28401-7503
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-9800
  • Fax: 910-343-8650
Mailing address:
  • Phone: 910-343-9800
  • Fax: 910-343-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number297627
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: