Organization
CAPE FEAR REGIONAL UROLOGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN WILSON (OFFICE MANAGER)
(910) 485-8801
Entity
Organization
Contact information
Practice address
1537 OWEN PARK LN, FAYETTEVILLE, NC 28304-3454
(910) 485-8801
(910) 485-5605
Mailing address
1537 OWEN PARK LN, FAYETTEVILLE, NC 28304-3454
(910) 485-8801
(910) 485-5605
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
9400496
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901823
—
NC
Enumeration date
04/25/2006
Last updated
01/09/2012
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