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NPI Code Detail

MEDICARE: WILMINGTON HEALTH PLLC

MEDICARE: WILMINGTON HEALTH PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician73991NC

General Provider Information

NPI Number : 1326350190
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILMINGTON HEALTH PLLC
Provider Business Mailing Address
First Line : 1202 MEDICAL CENTER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7307
Country : US
Telephone Number : 910-617-6705
Fax Number : 910-431-4048
Provider Business Practice Location Address
First Line : 4222 LONG BEACH RD SE
Second Line :
City : SOUTHPORT
State : NC
Zip : 28461-8627
Country : US
Telephone Number : 910-341-3300
Fax Number : 910-251-2067
Authorized Official
Title or Position : CBO DIRECTOR
Name : JEANETTE LOVELESS
Credential :
Telephone Number : 910-796-7730
Provider Enumeration Date : 07/09/2010
Last Update Date : 02/02/2023

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