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Individual

MARY SUZANNE HAMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 202-4615
Mailing address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 202-4615

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2010-00766
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1710034525
CHAMPUS
NC
05
5914630
NC
01
P00838856
RAILROAD MEDICARE
NC
Enumeration date
01/04/2007
Last updated
11/21/2013
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