Provider Demographics
NPI:1154521904
Name:THE CAPE FEAR CENTER FOR MEDICAL ARTS
Entity type:Organization
Organization Name:THE CAPE FEAR CENTER FOR MEDICAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILISSA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:ROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-343-0300
Mailing Address - Street 1:1222 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7332
Mailing Address - Country:US
Mailing Address - Phone:910-343-0300
Mailing Address - Fax:910-343-0332
Practice Address - Street 1:1222 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7332
Practice Address - Country:US
Practice Address - Phone:910-343-0300
Practice Address - Fax:910-343-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC9400118261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center