Organization
LUMBERTON MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA P BODIFORD (OFFICE MANAGER)
(910) 739-7551
Entity
Organization
Contact information
Practice address
395 W 27TH ST, LUMBERTON, NC 28358-3018
(910) 739-7551
(910) 739-2332
Mailing address
395 W 27TH ST, LUMBERTON, NC 28358-3018
(910) 739-7551
(910) 739-2332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40303
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89133Y2
—
NC
05
—
8914154
—
NC
05
—
8921108
—
NC
05
—
8928375
—
NC
05
—
8952432
—
NC
05
—
8971550
—
NC
Enumeration date
01/05/2007
Last updated
05/23/2008
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