Provider Demographics
NPI:1316937618
Name:OAK ISLAND MEDICAL CENTER, PA
Entity type:Organization
Organization Name:OAK ISLAND MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALMIRALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-278-3316
Mailing Address - Street 1:8715 E OAK ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:OAK ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28465-8367
Mailing Address - Country:US
Mailing Address - Phone:910-278-3316
Mailing Address - Fax:910-278-1415
Practice Address - Street 1:8715 E OAK ISLAND DR
Practice Address - Street 2:
Practice Address - City:OAK ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28465-8367
Practice Address - Country:US
Practice Address - Phone:910-278-3316
Practice Address - Fax:910-278-1415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902179Medicaid
NC02179OtherBCBS GRP PROV #
NC02179OtherBCBS GRP PROV #