Individual
MICHAL PAUL DOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7264 NC 211 BUS HWY S, BLADENBORO, NC 28320-6998
(910) 863-3139
Mailing address
7264 NC 211 BUS HWY S, BLADENBORO, NC 28320-6998
(910) 863-3139
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-009-022
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805695
—
NC
Enumeration date
01/09/2007
Last updated
07/09/2007
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