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Individual

DANIEL D FOTTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3421
(910) 371-1005
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(109) 341-1540
(910) 431-4048

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07376
NC
363A00000X
Physician Assistant
011023
NY
363AM0700X
Medical Physician Assistant
001746
CT

Other

Enumeration date
06/11/2006
Last updated
02/10/2025
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