Individual
DR. DANIEL JOHN BREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1202 MEDICAL CENTER DR, ATTN: CREDENTIALING, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 251-8824
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7680
(704) 316-9368
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125049041
IL
207R00000X
Internal Medicine Physician
ME 100992
FL
207RP1001X
Pulmonary Disease Physician
Primary
2012-00830
NC
Other
Enumeration date
11/14/2007
Last updated
10/25/2020
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