Organization
EASTERN SHORE DEVELOPMENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARNER MERRILL WIGGINS MD (OFFICAL)
(251) 402-5589
Entity
Organization
Contact information
Practice address
26420 KENSINGTON PL STE A, DAPHNE, AL 36526-5123
(251) 625-0400
Mailing address
26420 KENSINGTON PL STE A, DAPHNE, AL 36526-5123
(251) 625-0400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
00008950
AL
363L00000X
Nurse Practitioner
Primary
1076812
AL
Other
Enumeration date
06/02/2013
Last updated
06/02/2013
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