| Shipyard Medical Center | |
|
2632 Carolina Beach Rd Wilmington NC 28412-1806 | |
| (910) 409-0922 | |
| Not Available |
| Full Name | Shipyard Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2632 Carolina Beach Rd, Wilmington, North Carolina |
| Authorized Official Name and Position | Chris Donovin (OWNER) |
| Authorized Official Contact | 9199310490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shipyard Medical Center 2632 Carolina Beach Rd Wilmington NC 28412-1806 Ph: (910) 794-3939 | Shipyard Medical Center 2632 Carolina Beach Rd Wilmington NC 28412-1806 Ph: (910) 409-0922 |
| NPI Number | 1306050588 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 09/25/2007 |
| Medicare PECOS PAC ID | 6800980327 |
|---|---|
| Medicare Enrollment ID | O20070914000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306050588 | NPI | - | NPPES |
| 5906809 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | NC102817 (North Carolina) | Primary |
| Provider Name | Henry W Traylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588677736 PECOS PAC ID: 3971539586 Enrollment ID: I20071105000155 |
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