Organization
SOUTHEASTERN MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA MAYES WILSON (OFFICE MANAGER)
(910) 799-1810
Entity
Organization
Contact information
Practice address
637 S KERR AVE, WILMINGTON, NC 28403-8423
(910) 799-1810
(910) 452-2571
Mailing address
637 S KERR AVE, WILMINGTON, NC 28403-8423
(910) 799-1810
(910) 452-2571
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16755
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02701
BLUE CROSS BLUE SHIELD
NC
05
—
8902701
—
NC
Enumeration date
06/01/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us