Lake Waccamaw Primary Care, Pllc | |
107 Church St Lake Waccamaw NC 28450-1908 | |
(910) 646-6617 | |
(910) 646-6620 |
Full Name | Lake Waccamaw Primary Care, Pllc |
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Speciality | Family Medicine |
Location | 107 Church St, Lake Waccamaw, North Carolina |
Authorized Official Name and Position | Amy G Gaweda (PRESIDENT) |
Authorized Official Contact | 9106466617 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Waccamaw Primary Care, Pllc 121 Bretonshire Rd Wilmington NC 28405-4001 Ph: (910) 617-6202 | Lake Waccamaw Primary Care, Pllc 107 Church St Lake Waccamaw NC 28450-1908 Ph: (910) 646-6617 |
NPI Number | 1477795821 |
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Provider Enumeration Date | 04/01/2009 |
Last Update Date | 04/01/2009 |
Identifier | Type | State | Issuer |
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1477795821 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 92226 (North Carolina) | Primary |