Organization
WILMINGTON FAMILY PRACTICE PLLC
Active
Other names
Center For Quality Care, WILMINGTON FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE CROUSE (OFFICE MANAGER)
(910) 500-6451
Entity
Organization
Contact information
Practice address
3971 BUSINESS 17 E, BOLIVIA, NC 28422-8675
(910) 500-6451
(910) 500-6458
Mailing address
3971 BUSINESS 17 E, BOLIVIA, NC 28422-8675
(910) 500-6451
(910) 500-6458
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669918223
NPI
NC
05
—
1821295668
—
NC
05
—
1992351910
—
NC
Enumeration date
11/27/2019
Last updated
12/12/2024
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