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NPI Code Detail

MEDICARE: DANIEL ANDREW CULBRETH PA

MEDICARE: DANIEL ANDREW CULBRETH PA
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
1363A00000XPhysician Assistant101790NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1101790OTHERNCMEDICAL LICENSE

General Provider Information

NPI Number : 1982606638
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL ANDREW CULBRETH PA
Provider Business Mailing Address
First Line : 3787 SHIPYARD BLVD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6148
Country : US
Telephone Number : 910-332-3800
Fax Number : 910-763-8804
Provider Business Practice Location Address
First Line : 2716 ASHTON DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-2489
Country : US
Telephone Number : 910-332-3800
Fax Number : 910-763-8804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 09/10/2012

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Directions to “ DANIEL ANDREW CULBRETH PA” Practice Location

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