Open Water Medical, PA

Organization Active NPI General Practice Physician · Sea Level, NC

NPI 1003730169 · NPPES record last updated Aug 10, 2026

Key facts

NPI
1003730169
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
OPEN WATER MEDICAL, PA
Practice address
458 Hwy 70 East
Sea Level, NC 28577
Phone
(252) 728-5737
NPI assigned
Aug 10, 2026
Organization subpart
Yes
Parent organization (as reported)
OPEN WATER MEDICAL, PA

Authorized official

Name
Samuel Willis
Title
Coo
Phone
(252) 723-7234

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Open Water Medical PA (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

458 Hwy 70 East
Sea Level, NC 28577

Mailing address

1620C Live Oak St
Beaufort, NC 28516-1583
Phone (252) 728-5737

Other providers in Sea Level, NC

All providers in Sea Level, NC · General Practice Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.