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Organization

WILMINGTON HEALTH ACCESS FOR TEENS, INC

Active
Parent organization
WILMINGTON HEALTH ACCESS FOR TEENS, INC
Other names
New Hanover High School Wellness Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
WILMINGTON HEALTH ACCESS FOR TEENS, INC
Authorized official
MS. MARIA G VAN DE BOVENKAMP CMA (AAMA) (DIRECTOR OF ADMINISTRATION)
(910) 790-9949
Entity
Organization

Contact information

Practice address
4005 OLEANDER DR, WILMINGTON, NC 28403-6816
(910) 790-9949
(910) 790-9455
Mailing address
1307 MARKET ST, WILMINGTON, NC 28401-4331
(910) 763-4988
(910) 763-4990

Taxonomy

Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8701705
NC
Enumeration date
09/21/2006
Last updated
10/28/2010
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