Organization
COASTAL CAROLINA ANESTHESIOLOGIST, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN ZAKI DIMITRIOUS M.D. (PRESIDENT)
(910) 642-6427
Entity
Organization
Contact information
Practice address
500 JEFFERSON ST, WHITEVILLE, NC 28472-3634
(910) 642-6427
(910) 642-5769
Mailing address
PO BOX 505, WHITEVILLE, NC 28472-0505
(910) 642-6427
(910) 642-5769
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015KM
BC AND BS OF NC
NC
05
—
89015KM
—
NC
Enumeration date
02/07/2007
Last updated
08/22/2020
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