Organization
NEW HANOVER MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGO J ILLOBRE (BUSINESS OFFICE SUPERVISOR)
(910) 343-9991
Entity
Organization
Contact information
Practice address
1960 S 16TH ST, WILMINGTON, NC 28401-6647
(910) 343-9991
Mailing address
1960 S 16TH ST, WILMINGTON, NC 28401-6647
(910) 343-9991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41057
NC
207R00000X
Internal Medicine Physician
41057
NC
2085B0100X
Body Imaging Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890218J
—
NC
Enumeration date
05/26/2006
Last updated
11/11/2009
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