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Individual

MS. LOIS BEARD MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
7110 WRIGHTSVILLE AVE, SUITE B9, WILMINGTON, NC 28403-7219
(910) 509-4116
(910) 509-7566
Mailing address
7110 WRIGHTSVILLE AVE, SUITE B9, WILMINGTON, NC 28403-7219
(910) 509-4116
(910) 509-7566

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
9600064
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0247R
BCBS
NC
05
8954150
NC
Enumeration date
12/12/2006
Last updated
04/29/2013
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