Organization
MAGNOLIA FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ADAM GUTSIN D.O. (OWNER)
(910) 796-3212
Entity
Organization
Contact information
Practice address
3720 SHIPYARD BLVD, WILMINGTON, NC 28403-6147
(910) 796-3212
(910) 796-3216
Mailing address
3720 SHIPYARD BLVD, WILMINGTON, NC 28403-6147
(910) 796-3212
(910) 796-3216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9500364
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7937920
—
NC
Enumeration date
02/23/2009
Last updated
04/29/2020
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