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Individual

DR. ANTONIO E PUENTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1508 MILITARY CUTOFF ROAD, STE 303, WILMINGTON, NC 28403
(910) 509-9371
(910) 509-9372
Mailing address
1508 MILITARY CUTOFF ROAD, STE 303, WILMINGTON, NC 28403
(910) 509-9371
(910) 509-9372

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
NC0831
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04461
BCBS
Enumeration date
09/05/2006
Last updated
07/21/2015
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