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Organization
WHITEVILLE MEDICAL ASSOCIATES PA
Active
Organization
WHITEVILLE MEDICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY W TRAYLOR MD (PRESIDENT)
(910) 642-6121
Entity
Organization
Contact information
Practice address
823 JEFFERSON ST, WHITEVILLE, NC 28472
(910) 642-6121
(910) 642-8457
Mailing address
823 JEFFERSON ST, PO BOX 1528, WHITEVILLE, NC 28472
(910) 642-6121
(910) 642-8457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20979
NC
207R00000X
Internal Medicine Physician
24304
NC
208000000X
Pediatrics Physician
39134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7902940
—
NC
01
—
CD8805
RAILROAD MEDICARE CLINIC
NC
01
—
NPA538
SOUTH CAROLINA MEDICAID
SC
Enumeration date
01/02/2007
Last updated
02/22/2024
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