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General NPI Number Information
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NPI Number | 1659424588
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Entity Type | Organization
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Legal Business Name | JONATHAN NESTOR, MD, PA
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 601 E LAUCHWOOD DR
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City | LAURINBURG
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State | NC
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Zip | 28352-5510
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Country | US
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Telephone | 910-276-7727
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Fax | 910-277-7439
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Provider Business Mailing Address
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Address Line | PO BOX 1889
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City | LAURINBURG
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State | NC
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Zip | 28353-1889
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Country | US
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Telephone | 910-276-7727
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Fax | 910-277-7439
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JONATHAN NESTOR
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Credential | M.D.
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Telephone | 910-276-7727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 32548
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 32548
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License Number State | NC
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