Organization
COASTAL WOMENS CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAZIL A MOHAMED II MD (PHYSICIAN)
(910) 620-1053
Entity
Organization
Contact information
Practice address
1721 ALLENS LN, SUITE 102, WILMINGTON, NC 28403-3661
(910) 620-1053
Mailing address
1721 ALLENS LN, SUITE 102, WILMINGTON, NC 28403-3661
(910) 620-1053
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
201001263
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21041534
BCBSOFSC
SC
05
—
266429
—
SC
05
—
8906020
—
NC
Enumeration date
04/11/2012
Last updated
04/11/2012
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