Individual
DR. NANCY L CENTOFANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1706 MEDICAL PARK DR W, WILSON, NC 27893-2705
(252) 243-3223
(252) 243-3668
Mailing address
1706 MEDICAL PARK DR W, WILSON, NC 27893-2705
(410) 708-1036
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
198493
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
397641600
—
MD
01
—
68639503
BCBS MD
MD
01
—
F2320002
BCBS DC NCA
MD
Enumeration date
04/27/2006
Last updated
09/16/2020
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