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General NPI Number Information
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NPI Number | 1326350190
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Entity Type | Organization
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Legal Business Name | WILMINGTON HEALTH PLLC
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 4222 LONG BEACH RD SE
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City | SOUTHPORT
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State | NC
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Zip | 28461-8627
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Country | US
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Telephone | 910-341-3300
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Fax | 910-251-2067
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Provider Business Mailing Address
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Address Line | 1202 MEDICAL CENTER DR
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City | WILMINGTON
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State | NC
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Zip | 28401-7307
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Country | US
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Telephone | 910-617-6705
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Fax | 910-431-4048
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Authorized Official
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Title or Position | CBO DIRECTOR
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Name | JEANETTE LOVELESS
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Credential |
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Telephone | 910-796-7730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 73991
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License Number State | NC
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