Basic Information
| Provider Information | |||||||||
| NPI: | 1326350190 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILMINGTON HEALTH PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 600002 | ||||||||
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| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276756002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103413300 | ||||||||
| FaxNumber: | 9103413449 | ||||||||
| Practice Location | |||||||||
| Address1: | 4222 LONG BEACH RD SE | ||||||||
| Address2: | |||||||||
| City: | SOUTHPORT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284618627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103413300 | ||||||||
| FaxNumber: | 9104577650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2010 | ||||||||
| LastUpdateDate: | 05/06/2015 | ||||||||
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| AuthorizedOfficialLastName: | CHACE | ||||||||
| AuthorizedOfficialFirstName: | CHASITY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BUSINESS OFFICE | ||||||||
| AuthorizedOfficialTelephone: | 9103413300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 73991 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.