# BRUNSWICK FAMILY MEDICINE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396859872
- **Authorized official:** DR. SLADE ALAN SUCHECKI D.O. (PRESIDENT)
- **Authorized official phone:** (910) 454-4343

## Contact information

- **Practice address:** 3960 EXECUTIVE PARK BLVD, UNIT 600, SOUTHPORT, NC 28461
- **Practice address phone:** (910) 454-4343
- **Practice address fax:** (910) 457-9209
- **Mailing address:** 3960 EXECUTIVE PARK BLVD, UNIT 600, SOUTHPORT, NC 28461
- **Mailing address phone:** (910) 454-4343
- **Mailing address fax:** (910) 457-9209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2006
- **Last updated:** 09/25/2014