MEDICARE: TIA SERAN

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	171100000X	Acupuncturist	LAC-2308	NC

General Provider Information

NPI Number	:	1841127602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIA SERAN

Provider Business Mailing Address
First Line	:	113 BROOKVIEW RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28409-9132
Country	:	US
Telephone Number	:	541-606-1071
Fax Number	:

Provider Business Practice Location Address
First Line	:	3961A MARKET ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-1403
Country	:	US
Telephone Number	:	910-352-4555
Fax Number	:

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

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ TIA SERAN ” Practice Location

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