Organization
HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT LYSNE M,D., DIV. (DIRECTOR)
(910) 465-1935
Entity
Organization
Contact information
Practice address
20 S 16TH ST, WILMINGTON, NC 28401-4924
(910) 399-3927
(910) 399-3928
Mailing address
20 S 16TH ST, WILMINGTON, NC 28401-4924
(910) 399-3927
(910) 399-3928
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
200301378
NC
Other
Enumeration date
06/29/2009
Last updated
01/02/2014
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