Brunswick Urgent Care

Organization Active NPI Family Medicine Physician · Leland, NC

NPI 1124057740 · NPPES record last updated Nov 13, 2008

Key facts

NPI
1124057740
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BRUNSWICK URGENT CARE
Practice address
509 Olde Waterford Way
Suite 101
Leland, NC 28451
Phone
(910) 383-2182
NPI assigned
Jul 3, 2006
Organization subpart
No

Authorized official

Name
John Azzato, MD
Title
President
Phone
(910) 383-2182

National Provider Directory

Locations

509 Olde Waterford Way
Ste 101
Leland, NC 28451
Phone (910) 210-0656

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

509 Olde Waterford Way
Suite 101
Leland, NC 28451

Mailing address

PO Box 601790
Charlotte, NC 28260-1790
Phone (910) 383-2182

Other identifiers

IdentifierTypeStateIssuer
5902466MedicaidNC
DF1254OtherNCMEDICARE RR

Other providers in Leland, NC

All providers in Leland, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.