Individual
DR. JUSTIN DANIEL NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1915 S 17TH ST STE 101, WILMINGTON, NC 28401-6682
(910) 769-4590
(910) 769-4653
Mailing address
1915 S 17TH ST STE 101, WILMINGTON, NC 28401-6682
(910) 769-4590
(910) 769-4563
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2023-03120
NC
207W00000X
Ophthalmology Physician
24771
NE
207W00000X
Ophthalmology Physician
79768
GA
208D00000X
General Practice Physician
24771
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UPIN: VAD000
UPIN
—
Enumeration date
09/04/2008
Last updated
06/26/2025
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