Organization
SHOREVIEW MEDICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTY LAINE HALL CPT, CPC (OFFICE MANAGER)
(910) 458-8867
Entity
Organization
Contact information
Practice address
1328 N LAKE PARK BLVD, SUITE 102, CAROLINA BEACH, NC 28428-3945
(910) 458-8867
(910) 458-8764
Mailing address
PO BOX 317, CAROLINA BEACH, NC 28428-0317
(910) 458-8867
(910) 458-8764
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016AF
BLUE CROSS AND BLUE SHIEL
NC
05
—
89016AF
—
NC
Enumeration date
04/11/2006
Last updated
08/22/2020
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