Individual
DOMENIC A PALAGRUTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3599 GEORGE II HWY, SOUTHPORT, NC 28461-7793
(910) 845-3244
(910) 845-3276
Mailing address
3599 GEORGE II HWY, SOUTHPORT, NC 28461-9766
(910) 845-3244
(910) 845-3276
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13270
BC/BS NUMBER
NC
05
—
8913270
—
NC
Enumeration date
07/20/2005
Last updated
07/09/2007
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