Brunswick Family Medicine Pa

NPI 1396859872 - Family Medicine - 207Q00000X

NPI Details
NPI 1396859872
Enumeration Date 08/19/2006
Last Updated 09/25/2014
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name SLADE ALAN SLADE
Position PRESIDENT
Phone (910) 454-4343
Fax (910) 457-9209
Practice Location
3960 EXECUTIVE PARK BLVD
UNIT 600
SOUTHPORT NC, 28461, US
Phone (910) 454-4343
Fax (910) 457-9209
Business Location
3960 EXECUTIVE PARK BLVD
UNIT 600
SOUTHPORT NC, 28461, US
Phone (910) 454-4343
Fax (910) 457-9209
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Brunswick Family Medicine Pa NPI is 1396859872, taxonomy code is 207Q00000X Brunswick Family Medicine Pa physically located at 3960 Executive Park Blvd, Southport NC, 28461. NPI Number 1033115704 has the healthcare provider type.

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1396859872 NPI number is provided on an as is basis without warranty of any kind. 1396859872 is maintained by the National Plan & Provider Enumeration System. The contents of Brunswick Family Medicine Pa are for informational purposes only.