Provider Demographics
NPI:1104431725
Name:PROGRESS MEDICAL, PLLC
Entity type:Organization
Organization Name:PROGRESS MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-274-6718
Mailing Address - Street 1:2104 TALMAGE DR
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-9340
Mailing Address - Country:US
Mailing Address - Phone:910-274-6718
Mailing Address - Fax:910-782-0829
Practice Address - Street 1:1642 MILITARY CUTOFF RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5716
Practice Address - Country:US
Practice Address - Phone:910-274-6718
Practice Address - Fax:910-782-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2012-01439OtherDOH