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NPI Code Detail

MEDICARE: S E VONBIBERSTEIN M.D.

MEDICARE:   S E VONBIBERSTEIN  M.D.
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
1207Y00000XOtolaryngology Physician36066NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5CD6751OTHERRAIL ROAD MEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12525526OTHERNCCIGNA PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
459476OTHERNCMEDCOST
601157OTHERNCBCBS NC GROUP

General Provider Information

NPI Number : 1548221690
Entity Type Code : Individual
Provider Name (Legal Business Name) : S E VONBIBERSTEIN M.D.
Provider Business Mailing Address
First Line : 2311 DELANEY RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6012
Country : US
Telephone Number : 910-762-8754
Fax Number : 910-762-0778
Provider Business Practice Location Address
First Line : 2311 DELANEY RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6012
Country : US
Telephone Number : 910-762-8754
Fax Number : 910-762-0778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 05/31/2012

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Directions to “ S E VONBIBERSTEIN M.D.” Practice Location

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