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General NPI Number Information
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NPI Number | 1386849800
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Entity Type | Organization
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Legal Business Name | ALBEMARLE MEDICAL SPECIALIST,LLC
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 MEDICAL DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3361
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Country | US
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Telephone | 252-338-5183
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Fax | 525-338-5669
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Provider Business Mailing Address
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Address Line | 100 MEDICAL DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3361
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Country | US
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Telephone | 252-338-5183
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Fax | 525-338-5669
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Authorized Official
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Title or Position | CEO
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Name | DR. STEVEN P MANULI
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Credential | MD
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Telephone | 252-338-5183
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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 | 9601393
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License Number State | NC
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