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Organization
WILMINGTON MEDICAL GROUP PA
Active
Organization
WILMINGTON MEDICAL GROUP PA
Active
Other names
Sneads Ferry Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HENRY PRIDGEN M.D. (MEDICAL DIRECTOR)
(910) 327-2015
Entity
Organization
Contact information
Practice address
1319 NC HIGHWAY 210, SNEADS FERRY, NC 28460-9144
(910) 327-2015
(910) 251-7777
Mailing address
1925A OLEANDER DR, WILMINGTON, NC 28403-2334
(910) 251-8851
(910) 251-7777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29495
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015V4
BCBS
NC
01
—
230038
MEDICARE
NC
05
—
89015V4
—
NC
Enumeration date
01/29/2007
Last updated
11/20/2007
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