Individual
IMMACULA SAINT-LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
303 GREEN ST E, WILSON, NC 27893-4105
(252) 243-9800
Mailing address
303 GREEN ST E, WILSON, NC 27893-4105
(252) 243-9800
(252) 243-9888
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
2005-01289
NC
208000000X
Pediatrics Physician
151877
MA
208000000X
Pediatrics Physician
Primary
2005-01289
NC
208000000X
Pediatrics Physician
D0088037
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3196209
—
MA
Enumeration date
09/20/2006
Last updated
03/27/2024
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