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Individual

ALFRED DE MARIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1222 MEDICAL CENTER DR, ATTN: CREDENTIALING, WILMINGTON, NC 28401-7307
(910) 341-3383
(910) 341-3321
Mailing address
2511 DELANEY AVE, WILMINGTON, NC 28403-6003
(910) 772-9202
(866) 345-8963

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
21641
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130013806
RAILROAD MEDICARE
NC
01
28311
BCBS NC
NC
05
8928311
NC
Enumeration date
08/29/2006
Last updated
06/06/2014
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