Coastal Urology PLLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

9700005 Issued in NC

Legal business name

COASTAL UROLOGY PLLC

Practice address

1099 Medical Center Dr
Ste 101
Wilmington, NC 28401-7367

Phone

(910) 254-9995

Fax

(910) 254-9996

NPI assigned

Jun 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Victor Elias Abraham III, MD

Title

President

Phone

(910) 254-9995

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1417150236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 MEDICAL CENTER DR",
            "address_2": "STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017367",
            "telephone_number": "910-254-9995",
            "fax_number": "910-254-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 MEDICAL CENTER DR",
            "address_2": "STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017367",
            "telephone_number": "910-254-9995",
            "fax_number": "910-254-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL UROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "ELIAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-254-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": "9700005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.