Organization
COASTAL INTERNAL MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA CAPORINO (OFFICE MANAGER)
(910) 763-3738
Entity
Organization
Contact information
Practice address
2032 S 17TH ST, STE. 101, WILMINGTON, NC 28401-6629
(910) 763-3738
(910) 763-0454
Mailing address
2032 S 17TH ST, STE. 101, WILMINGTON, NC 28401-6629
(910) 763-3738
(910) 763-0454
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011C0
BCBS
NC
05
—
5906247
—
NC
Enumeration date
09/30/2005
Last updated
11/05/2008
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