Organization
BOILING SPRING LAKES FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMENIC A PALAGRUTO II D.O. (OWNER)
(910) 845-3244
Entity
Organization
Contact information
Practice address
3599 GEORGE II HWY, SOUTHPORT, NC 28461-7793
(910) 845-3244
(910) 845-3276
Mailing address
3599 GEORGE II HWY, SOUTHPORT, NC 28461-7793
(910) 845-3244
(910) 845-3276
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8913720
—
NC
Enumeration date
10/05/2006
Last updated
08/22/2020
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