Boiling Spring Lakes Family Medicine, Pc | |
3599 George Ii Hwy Southport NC 28461-7793 | |
(910) 845-3244 | |
(910) 845-3276 |
Full Name | Boiling Spring Lakes Family Medicine, Pc |
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Speciality | Family Medicine |
Location | 3599 George Ii Hwy, Southport, North Carolina |
Authorized Official Name and Position | Domenic A Palagruto (OWNER) |
Authorized Official Contact | 9108453244 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Boiling Spring Lakes Family Medicine, Pc 3599 George Ii Hwy Southport NC 28461-7793 Ph: (910) 845-3244 | Boiling Spring Lakes Family Medicine, Pc 3599 George Ii Hwy Southport NC 28461-7793 Ph: (910) 845-3244 |
NPI Number | 1730275090 |
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Provider Enumeration Date | 10/05/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 6901868587 |
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Medicare Enrollment ID | O20041027000764 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730275090 | NPI | - | NPPES |
8913720 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (North Carolina) | Primary |
Provider Name | Domenic Anthony Palagruto |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215936356 PECOS PAC ID: 5193709749 Enrollment ID: I20040614000540 |
Provider Name | Karen E Wood |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649340902 PECOS PAC ID: 9133229230 Enrollment ID: I20070702000482 |
Provider Name | Donald E Binz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043271158 PECOS PAC ID: 5092768812 Enrollment ID: I20231016000079 |
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