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Individual

MICHAEL PAUL MOULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 332-1072
Mailing address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 332-1072

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9400946
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-28836
UNITED HEALTHCARE
NC
01
61180
BCBS
NC
05
8961180
NC
01
930077048
RAILROAD MEDICARE
NC
01
930084660
RAILROAD MEDICARE
NC
01
B4550
MEDCOST
NC
05
Q00946
SC
Enumeration date
06/15/2005
Last updated
11/24/2009
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