Organization
WACCAMAW ULTRASOUND & DIAGNOSTICS
Active
Other names
Medical Center Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY GRIGSBY (PRESIDENT)
(910) 642-9085
Entity
Organization
Contact information
Practice address
112 E WHITE OAK ST, LAKE WACCAMAW, NC 28450-2128
(910) 642-9085
Mailing address
1515 MEDICAL CENTER DR, WILMINGTON, NC 28401-7507
(910) 642-9085
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890129L
—
NC
Enumeration date
09/22/2011
Last updated
09/22/2011
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