| Coastal Infectious Disease Consultants | |
|
2310 Delaney Rd Wilmington NC 28403-6013 | |
| (910) 763-4511 | |
| (910) 763-6608 |
| Full Name | Coastal Infectious Disease Consultants |
|---|---|
| Speciality | Internal Medicine |
| Location | 2310 Delaney Rd, Wilmington, North Carolina |
| Authorized Official Name and Position | John W Sanders (OWNER) |
| Authorized Official Contact | 9107634511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Infectious Disease Consultants 2310 Delaney Rd Wilmington NC 28403-6013 Ph: (910) 763-4511 | Coastal Infectious Disease Consultants 2310 Delaney Rd Wilmington NC 28403-6013 Ph: (910) 763-4511 |
| NPI Number | 1528154473 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7719992544 |
|---|---|
| Medicare Enrollment ID | O20060215000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528154473 | NPI | - | NPPES |
| 018HC | Other | NC | BCBSNC PROVIDER |
| 5902944 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | John W Sanders |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1184717183 PECOS PAC ID: 8628083458 Enrollment ID: I20060220000026 |
| Provider Name | Aman Jitendra Pathak |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124114178 PECOS PAC ID: 1951309236 Enrollment ID: I20061121000207 |
| Provider Name | Crystal A Lublin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003277948 PECOS PAC ID: 7618262742 Enrollment ID: I20160829000211 |
| Provider Name | Sara Anne Valasek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548705049 PECOS PAC ID: 2062798085 Enrollment ID: I20170405002242 |
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