Organization
COASTAL CAROLINA PSYCHIATRIC SERVICES PLLC
Active
Organization
COASTAL CAROLINA PSYCHIATRIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BUSH KAVURU M.D (MEMBER-MANAGER)
(252) 265-9680
Entity
Organization
Contact information
Practice address
1708 LAKESIDE DR NW, WILSON, NC 27896-1800
(252) 265-9680
(252) 265-9680
Mailing address
1708 LAKESIDE DR NW, WILSON, NC 27896-1800
(252) 265-9680
(252) 265-9680
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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