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General NPI Number Information
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NPI Number | 1932318623
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Entity Type | Organization
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Legal Business Name | LUMBERTON OBSTETRICS & GYNECOLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 1003 WOODRIDGE DR.
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City | LUMBERTON
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State | NC
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Zip | 28358
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Country | US
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Telephone | 910-738-9601
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Fax | 910-671-8264
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Provider Business Mailing Address
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Address Line | 1003 WOODRIDGE DR.
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City | LUMBERTON
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State | NC
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Zip | 28358
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Country | US
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Telephone | 910-738-9601
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Fax | 910-671-8264
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHERYL A BECKER
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Credential |
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Telephone | 910-738-9601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 200700743
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License Number State | NC
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