Organization
COASTAL CHILDRENS SERVICES PLLC
Active
Other names
CCS Wilmington
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERNANDO R. MOYA MD (OWNER)
(910) 667-5011
Entity
Organization
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Mailing address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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