Individual
MR. ANDREW N. ILLOBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6419 CAROLINA BEACH RD, SUITE A, WILMINGTON, NC 28412-2759
(910) 790-3660
Mailing address
6419 CAROLINA BEACH RD, SUITE A, WILMINGTON, NC 28412-2759
(910) 790-3660
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102115
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89015C3
—
NC
Enumeration date
11/13/2006
Last updated
06/04/2025
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