MEDICARE: NOAH R ARCHER JR. MD

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
1	208000000X	Pediatrics Physician	35255	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1228864	OTHER	NC	UHC
2	561980160X7	OTHER	NC	CIGNA
3	11952	OTHER	NC	BCBS NC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	89465	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1568576213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH R ARCHER JR. MD

Provider Business Mailing Address
First Line	:	1202 MEDICAL CENTER DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-7307
Country	:	US
Telephone Number	:	910-341-3300
Fax Number	:	910-341-3321

Provider Business Practice Location Address
First Line	:	2421 SILVER STREAM LANE
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-0000
Country	:	US
Telephone Number	:	910-763-2072
Fax Number	:	910-763-1586

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	04/15/2021

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Directions to “ NOAH R ARCHER JR. MD” Practice Location

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