Organization
DUPLIN SURGICAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYREK MILLER M.D. (OWNER)
(910) 275-0027
Entity
Organization
Contact information
Practice address
417 N MAIN STREET, SUITE B, KENANSVILLE, NC 28349
(910) 275-0027
Mailing address
PO BOX 490, KENANSVILLE, NC 28349-0490
(910) 275-0027
(910) 296-0214
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1334X
BCBS OF NORTH CAROLINA
—
05
—
5900856
—
NC
Enumeration date
02/07/2008
Last updated
02/07/2008
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