Individual
AVITUS MAROBA ITOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4155 FERNCREEK DR, FAYETTEVILLE, NC 28314-2581
(910) 425-5999
(910) 920-4313
Mailing address
3632 LUTON CT, CHARLOTTE, NC 28262-2648
(704) 974-1354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5010863
NC
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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