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General NPI Number Information
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NPI Number | 1962477877
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Entity Type | Individual
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Provider Name | DOUGLAS J TESTORI D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 11/07/2014
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Provider Practice Location Address
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Address Line | 1520 PHYSICIANS DR
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City | WILMINGTON
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State | NC
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Zip | 28401-7356
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Country | US
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Telephone | 910-763-5182
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Fax | 910-763-0291
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Provider Business Mailing Address
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Address Line | PO BOX 602484
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City | CHARLOTTE
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State | NC
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Zip | 28260-2484
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Country | US
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Telephone | 910-763-0291
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Fax | 910-763-0291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 2005-00851
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License Number State | NC
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