# SHALOM MEDICAL PC

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

## Provider details

- **NPI number:** 1467759985
- **Authorized official:** DR. BENJAMIN CHUKWUNONSO MOZIE MD (MEDICAL DIRECTOR/PRESIDENT)
- **Authorized official phone:** (731) 334-9011

## Contact information

- **Practice address:** 1102 HENDERSON DR, JACKSONVILLE, NC 28540-5203
- **Practice address phone:** (731) 334-9011
- **Practice address fax:** (731) 288-1628
- **Mailing address:** 1102 HENDERSON DR, JACKSONVILLE, NC 28540-5203
- **Mailing address phone:** (731) 334-9011
- **Mailing address fax:** (731) 288-1628

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 2010-01876 | NC | Yes |

## Other

- **Enumeration date:** 02/18/2011
- **Last updated:** 02/18/2011