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Organization
WILMINGTON INTERNAL MEDICINE PA
Active
Organization
WILMINGTON INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY MICHELLE YOUNG (PRACTICE MANAGER)
(910) 762-4600
Entity
Organization
Contact information
Practice address
2215 CANTERWOOD DR, WILMINGTON, NC 28401-7301
(910) 762-4600
(910) 762-9483
Mailing address
2215 CANTERWOOD DR, WILMINGTON, NC 28401-7301
(910) 762-4600
(910) 762-9483
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
85716
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176C
BLUE CROSS PROVIDER #
NC
05
—
7978365
—
NC
Enumeration date
03/12/2007
Last updated
12/27/2012
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