SOUTHPORT INTERNAL MEDICINE PA NPI 1528365657

NPI Information

NPI: 1528365657
Provider Name: SOUTHPORT INTERNAL MEDICINE PA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address: 1513 N HOWE ST
UNIT 6
SOUTHPORT, NC
ZIP 28461
Phone: (910) 457-9127

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NPI Details

SOUTHPORT INTERNAL MEDICINE PA is an internal medicine in Southport, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SOUTHPORT INTERNAL MEDICINE PA NPI is 1528365657. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1513 N HOWE ST
UNIT 6
SOUTHPORT, NC
ZIP 28461-769
Phone: (910) 457-9127
Fax: (910) 269-2884

The provider's authorized official is Douglas K Hiltz .
The authorized official title is President and has the following contact phone number (910) 457-9127.

The enumeration date for this NPI number is 2/25/2011 and was last updated on 7/6/2011.

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	207R00000X	Internal Medicine		33376	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	34D0246020	OTHER	NORTH CAROLINA	CLIA WAIVED CERTIFICATE
2	11502	MEDICARE PIN	NORTH CAROLINA
3	C201101100100-1	OTHER	NORTH CAROLINA	DEPT OF THE SECRETARY OF STATE CERTIFICATION NUMBER

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: 3/30/2025

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