Organization
LUMBERTON INTERNAL MEDICINE GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAC ADOLPH MONTILUS MD (PRESIDENT)
(910) 272-8800
Entity
Organization
Contact information
Practice address
4314 LUDGATE ST, LUMBERTON, NC 28358-2461
(910) 272-8800
(910) 272-0508
Mailing address
4314 LUDGATE ST, LUMBERTON, NC 28358-2461
(910) 272-8800
(910) 272-0508
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
97.01503
NC
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014KA
BCBS
NC
05
—
89014KA
—
NC
Enumeration date
06/07/2006
Last updated
10/17/2025
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