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General NPI Number Information
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NPI Number | 1730044207
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Entity Type | Organization
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Legal Business Name | WILLOW BROOK FAMILY MEDICINE
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2108 CAPITAL DR STE 102
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City | WILMINGTON
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State | NC
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Zip | 28405-6477
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Country | US
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Telephone | 801-682-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 7012 BAYOU CT
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City | WILMINGTON
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State | NC
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Zip | 28411-0200
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Country | US
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Telephone | 801-682-6510
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH MOJAZZA
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Credential | PA
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Telephone | 801-682-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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