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Individual

VIRGIL E BEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 442-1100
(910) 442-1199
Mailing address
PO BOX 3686, WILMINGTON, NC 28406-0686
(910) 442-1100
(910) 442-1199

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30281
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
204687F
MEDICARE PTAN
NC
01
204687H
MEDICARE PTAN
NC
05
8914076
NC
01
P00843363
MEDICARE RAILROAD
NC
Enumeration date
06/22/2005
Last updated
06/03/2011
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