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Organization
COASTAL CAROLINA INTERNAL MEDICINE, PA
Active
Organization
COASTAL CAROLINA INTERNAL MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MITZI M ROS R.N (OFFICE MANAGER)
(910) 937-0008
Entity
Organization
Contact information
Practice address
2420 HENDERSON DR, JACKSONVILLE, NC 28546-5254
(910) 937-0008
(910) 937-0098
Mailing address
2420 HENDERSON DR, JACKSONVILLE, NC 28546-5254
(910) 937-0008
(910) 937-0098
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
200200443
NC
Other
Enumeration date
07/13/2006
Last updated
10/30/2019
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