Provider Type Icon

RETINA OF COASTAL CAROLINA PLLC NPI 1326089442


NPI Information

NPI: 1326089442
Provider Name: RETINA OF COASTAL CAROLINA, PLLC
Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

CLIA Number: 34D2080636

Address:
1801 NEW HANOVER MEDICAL PARK DR
WILMINGTON, NC
ZIP 28403
Phone: (910) 254-2023
Get Directions

RETINA OF COASTAL CAROLINA, PLLC is a retina specialist ophthalmology in Wilmington, NC. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. RETINA OF COASTAL CAROLINA, PLLC NPI is 1326089442. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1801 NEW HANOVER MEDICAL PARK DR
WILMINGTON, NC
ZIP 28403-351
Phone: (910) 254-2023
Fax: (910) 254-0242

The provider's authorized official is Igor Westra .
The authorized official title is Managing Partner and has the following contact phone number (910) 254-2023.

The CLIA number assigned to this NPI record is 34D2080636 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2006 and was last updated on 1/10/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207WX0108XOphthalmologyUveitis and Ocular Inflammatory DiseaseNo
2207WX0107XOphthalmologyRetina SpecialistYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1QPA675MEDICAIDSOUTH CAROLINA
201315OTHERNORTH CAROLINABCBS OF NORTH CAROLINA
3790129CMEDICAIDNORTH 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.