Wendy P Moeller, MD
Individual provider Active NPI Gastroenterology Physician · Pollocksville, NC
NPI 1255324356 · NPPES record last updated Mar 17, 2017
Key facts
- NPI
- 1255324356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 26131 (NC)
- Practice address
- 137 Medical Lane
Pollocksville, NC 28573 - Phone
- (252) 633-1010
- Fax
- (252) 224-3071
- NPI assigned
- Aug 24, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26131 | NC | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinaeast Medical Center | Past | Accepting new patients | |
| Carolinaeast Health System Auxiliary | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 26131 | NC | Yes |
Addresses
Primary practice location
137 Medical Lane
Pollocksville, NC 28573
Mailing address
PO Box 896206
Charlotte, NC 28289-6206
Phone (252) 633-1010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8959924 | Medicaid | NC | |
| 208940C | Other | NC | MEDICARE PTAN |
| 59924 | Other | NC | BLUE CROSS |
Other providers in Pollocksville, NC
- Joseph Anthony Marcantel
- Kathy Ann Marks
- Kacia Kristin McCaghren Bray
- Gerard M McPhee
- Mark B Moeller
- Melba R Perry
- Realo Discount Drug of Pollocksville
- Evan Ryan Restelli
- Jonathan Rivera Diaz
- Terrence Simmons
All providers in Pollocksville, NC · Gastroenterology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.