| Coastal Internal Medicine, P.a. | |
|
2032 S 17th St Ste. 101 Wilmington NC 28401-6629 | |
| (910) 763-3738 | |
| (910) 763-0454 |
| Full Name | Coastal Internal Medicine, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2032 S 17th St, Wilmington, North Carolina |
| Authorized Official Name and Position | Laura Caporino (OFFICE MANAGER) |
| Authorized Official Contact | 9107633738 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Internal Medicine, P.a. 2032 S 17th St Ste. 101 Wilmington NC 28401-6629 Ph: (910) 763-3738 | Coastal Internal Medicine, P.a. 2032 S 17th St Ste. 101 Wilmington NC 28401-6629 Ph: (910) 763-3738 |
| NPI Number | 1437146800 |
|---|---|
| Provider Enumeration Date | 09/30/2005 |
| Last Update Date | 11/05/2008 |
| Medicare PECOS PAC ID | 9133181886 |
|---|---|
| Medicare Enrollment ID | O20080327000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437146800 | NPI | - | NPPES |
| 5906247 | Medicaid | NC | |
| 011C0 | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ayman Gebrail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033105507 PECOS PAC ID: 8022193515 Enrollment ID: I20080307000389 |
| Provider Name | David W Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356570188 PECOS PAC ID: 3779636725 Enrollment ID: I20090808000127 |
| Provider Name | Amanda Jo Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821338252 PECOS PAC ID: 6103061890 Enrollment ID: I20130329000150 |
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