Organization
SHOEHEEL MEDICAL ARTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MICHAEL SULLIVAN PHYSICIAN ASSISTANT (ADMINISTRATOR)
(910) 844-5681
Entity
Organization
Contact information
Practice address
102 PINE STREET, MAXTON, NC 28364-1262
(910) 844-5681
(910) 844-5650
Mailing address
102 PINE STREET, MAXTON, NC 28364-1262
(910) 844-5681
(910) 844-5650
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343878A
—
NC
05
—
343878C
—
NC
Enumeration date
10/18/2006
Last updated
10/21/2008
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