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Individual

KEVIN S SCULLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2716 ASHTON DR, WILMINGTON, NC 28412-2489
(910) 332-3800
(910) 251-0421
Mailing address
2716 ASHTON DR, WILMINGTON, NC 28412-2489
(910) 332-3800
(910) 251-0421

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
28340
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
28340
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8975089
NC
01
P01048395
RR MEDICARE
Enumeration date
04/24/2006
Last updated
07/26/2012
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