Individual
DMITRY TVERSKOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2520 TROY DR, WILMINGTON, NC 28401-7661
(910) 444-7086
Mailing address
5130 TRUMPET VINE WAY, WILMINGTON, NC 28412-6263
(908) 548-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5014421
NC
363LF0000X
Family Nurse Practitioner
5014421
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5014421
NC
Other
Enumeration date
05/17/2021
Last updated
10/06/2022
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