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General NPI Number Information
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NPI Number | 1700104775
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Entity Type | Organization
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Legal Business Name | BURGAW MEDICAL CENTER, P.C.
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 25 N HAMPSTEAD VILLAGE DR
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City | HAMPSTEAD
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State | NC
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Zip | 28443-3932
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Country | US
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Telephone | 910-803-0340
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Fax | 910-803-0342
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Provider Business Mailing Address
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Address Line | 25 N HAMPSTEAD VILLAGE DR
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City | HAMPSTEAD
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State | NC
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Zip | 28443-3932
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Country | US
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Telephone | 910-803-0340
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Fax | 910-803-0342
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Authorized Official
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Title or Position | OWNER
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Name | MOSTAFA MOHAMED REZK
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Credential | DO
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Telephone | 910-803-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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