# LUMBERTON INTERNAL MEDICINE GROUP

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

## Provider details

- **NPI number:** 1477627180
- **Authorized official:** DR. MAC ADOLF MONTILUS M.D. (DR. MAC MONTILUS, MD)
- **Authorized official phone:** (910) 272-8800

## Contact information

- **Practice address:** 4314 LUDGATE ST, LUMBERTON, NC 28358-2461
- **Practice address phone:** (910) 272-8800
- **Practice address fax:** (910) 272-0508
- **Mailing address:** 4314 LUDGATE ST, LUMBERTON, NC 28358-2461
- **Mailing address phone:** (910) 272-8800
- **Mailing address fax:** (910) 272-0508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NC | Yes |
| 207R00000X | Internal Medicine Physician | 97-01503 | NC | — |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014KA | BCBS\# | NC |
| 05 | — | 89014KA | — | NC |
| 05 | — | 891079Q | — | NC |
| 05 | — | 891368C | — | NC |