Organization
ATLANTIC UROLOGY PC
Active
Organization
ATLANTIC UROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J MYNATT MD (OWNER)
(910) 362-8765
Entity
Organization
Contact information
Practice address
1606 PHYSICIANS DR, SUITE 101, WILMINGTON, NC 28401-7361
(910) 362-8765
(910) 362-9123
Mailing address
PO BOX 600085, RALEIGH, NC 27675-6085
(910) 362-8765
(910) 362-9123
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011MU
—
NC
Enumeration date
07/07/2006
Last updated
09/05/2008
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