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General NPI Number Information
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NPI Number | 1003821547
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Entity Type | Organization
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Legal Business Name | WILMINGTON SURGICAL ASSOCIATES PA
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2739 IRON GATE DR
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City | WILMINGTON
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State | NC
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Zip | 28412-3731
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Country | US
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Telephone | 910-763-7363
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Fax | 910-251-8296
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Provider Business Mailing Address
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Address Line | 2739 IRON GATE DR
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City | WILMINGTON
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State | NC
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Zip | 28412-3731
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Country | US
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Telephone | 910-763-7363
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Fax | 910-251-8296
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | CHAD MARTIN
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Credential |
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Telephone | 910-763-7363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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