| Ave Maria Family Practice, Pllc | |
|
1230 Medical Center Dr Wilmington NC 28401 | |
| (910) 799-5452 | |
| (910) 799-5479 |
| Full Name | Ave Maria Family Practice, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1230 Medical Center Dr, Wilmington, North Carolina |
| Authorized Official Name and Position | Dorothy Ejinkonye Agbafe-mosley (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9107995452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ave Maria Family Practice, Pllc Po Box 16663 Wilmington NC 28408-6663 Ph: (910) 799-5452 | Ave Maria Family Practice, Pllc 1230 Medical Center Dr Wilmington NC 28401 Ph: (910) 799-5452 |
| NPI Number | 1215205539 |
|---|---|
| Provider Enumeration Date | 12/01/2011 |
| Last Update Date | 07/17/2018 |
| Medicare PECOS PAC ID | 4981870102 |
|---|---|
| Medicare Enrollment ID | O20120110000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215205539 | NPI | - | NPPES |
| 5915683 | Medicaid | NC |
| Provider Name | Dorothy E Agbafe-mosley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881898187 PECOS PAC ID: 5597899518 Enrollment ID: I20120222000227 |
| Provider Name | Valerie Cousins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932332376 PECOS PAC ID: 9830215102 Enrollment ID: I20161003002574 |
| Provider Name | Elizabeth Ashley Triplett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073173126 PECOS PAC ID: 8628304508 Enrollment ID: I20190730004057 |
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