Individual
LIUDMILA YESAULAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5345
(910) 662-9300
(910) 662-2401
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-9300
(910) 662-2401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018-01980
NC
207R00000X
Internal Medicine Physician
78251
GA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2018-01980
NC
390200000X
Student in an Organized Health Care Education/Training Program
200999
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018-01980
STATE LICENSE
NC
Enumeration date
04/01/2014
Last updated
03/07/2023
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