Organization
COASTAL MOBILE MEDICAL DOCTOR, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NARENDER DEIVASEKHAMANI ARCOT MD (PRESIDENT AND CEO)
(910) 355-6696
Entity
Organization
Contact information
Practice address
203 STAGECOACH DR, JACKSONVILLE, NC 28546-9617
(910) 355-6696
(910) 355-6696
Mailing address
203 STAGECOACH DR, JACKSONVILLE, NC 28546-9617
(910) 355-6696
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
200100829
NC
Other
Enumeration date
08/07/2008
Last updated
11/20/2008
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