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Individual

DOUGLAS NEDEROSTEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
Mailing address
PO BOX 409540, ATLANTA, GA 30384-9540

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
99-00309
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891219F
NC
Enumeration date
09/01/2006
Last updated
07/09/2007
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