Individual
SAMUEL FERNANDO MEJIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
703 IRELAND CT, JACKSONVILLE, NC 28546-1637
(910) 353-1518
Mailing address
703 IRELAND CT, JACKSONVILLE, NC 28546-1637
(910) 353-1518
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301325B
—
NC
Enumeration date
02/12/2007
Last updated
09/11/2025
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