AVE MARIA FAMILY PRACTICE PLLC NPI 1215205539

NPI Information

NPI: 1215205539
Provider Name: AVE MARIA FAMILY PRACTICE, PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1230 MEDICAL CENTER DR
WILMINGTON, NC
ZIP 28401
Phone: (910) 799-5452
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AVE MARIA FAMILY PRACTICE, PLLC is a family medicine in Wilmington, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. AVE MARIA FAMILY PRACTICE, PLLC NPI is 1215205539. The provider is registered as an organization entity type.

The provider's business location address is:

1230 MEDICAL CENTER DR
WILMINGTON, NC
ZIP 28401
Phone: (910) 799-5452
Fax: (910) 799-5479

The provider's authorized official is Dorothy Ejinkonye Agbafe-mosley .
The authorized official title is Medical Director and has the following contact phone number (910) 799-5452.

The enumeration date for this NPI number is 12/1/2011 and was last updated on 7/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	179288	NORTH CAROLINA	No
2	261QP2300X	Clinic/Center	Primary Care	2009-01999	NORTH CAROLINA	No
3	207Q00000X	Family Medicine		2009-01999	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5915683	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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