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General NPI Number Information
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NPI Number | 1417061011
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Entity Type | Organization
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Legal Business Name | ABC PEDIATRICS OF DUNN, PA
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 104 TILGHMAN DR
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City | DUNN
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State | NC
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Zip | 28334-5533
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Country | US
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Telephone | 910-892-1333
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Fax | 910-892-2757
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Provider Business Mailing Address
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Address Line | 104 TILGHMAN DR
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City | DUNN
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State | NC
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Zip | 28334-5533
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Country | US
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Telephone | 910-892-1333
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Fax | 910-892-2757
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Authorized Official
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Title or Position | OWNER
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Name | VINCENT CHIODO
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Credential | MD
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Telephone | 910-892-1333
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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 | 58998
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License Number State | NC
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