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Organization
LAKE WACCAMAW PRIMARY CARE, PLLC
Active
Organization
LAKE WACCAMAW PRIMARY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY G GAWEDA FNP (PRESIDENT)
(910) 646-6617
Entity
Organization
Contact information
Practice address
107 CHURCH ST, LAKE WACCAMAW, NC 28450-1908
(910) 646-6617
(910) 646-6620
Mailing address
121 BRETONSHIRE RD, WILMINGTON, NC 28405-4001
(910) 617-6202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
92226
NC
Other
Enumeration date
04/01/2009
Last updated
04/01/2009
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