Organization
WILMINGTON GASTROENTEROLOGY ENDOSCOPY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN LEE PETERSON JR. MBA (PRACTICE ADMINISTRATOR)
(910) 362-1011
Entity
Organization
Contact information
Practice address
5115 OLEANDER DRIVE, WILMINGTON, NC 28403-7018
(910) 362-1011
(910) 362-1012
Mailing address
5115 OLEANDER DRIVE, WILMINGTON, NC 28403-7018
(910) 362-1011
(910) 362-1012
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0091
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS0091
ASC LICENSE NUMBER
NC
Enumeration date
05/07/2007
Last updated
01/09/2014
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