Organization
NOVA URGENT CARE PAMLICO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DONNELLY (MANAGER)
(252) 672-0095
Entity
Organization
Contact information
Practice address
13808 HWY 55, ALLIANCE, NC 28509
(252) 745-7440
(252) 672-9897
Mailing address
1813 S GLENBURNIE RD, NEW BERN, NC 28562-5210
(252) 672-0095
(252) 672-9897
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NC
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
NC
363A00000X
Physician Assistant
001000560
NC
363L00000X
Nurse Practitioner
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2324658
MEDICARE GROUP ID NUMBER
NC
05
—
5903188
—
NC
Enumeration date
06/26/2006
Last updated
01/12/2015
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