Seaside Internal Medicine PLLC

Key facts

NPI

1831155415

Entity type

Organization (NPI type 2)

Primary specialty

Internal Medicine Physician 207R00000X

Legal business name

SEASIDE INTERNAL MEDICINE PLLC

Practice address

1328 N Lake Park Blvd
Suite 106
Carolina Beach, NC 28428-3945

Phone

(910) 458-5750

Fax

(910) 458-5770

NPI assigned

Apr 24, 2006

Organization subpart

No

Authorized official

Name

Ms. Sara L Christiansen, MD

Title

Owner Medical Director

Phone

(910) 458-5750

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831155415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "284280311",
            "telephone_number": "910-458-5750",
            "fax_number": "910-458-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 N LAKE PARK BLVD",
            "address_2": "SUITE 106",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "284283945",
            "telephone_number": "910-458-5750",
            "fax_number": "910-458-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-458-5750",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "138XP",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900288",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina Beach, NC

• Meghan Elizabeth Richardson
• Howard Ruscetti, MD
• Jeanie Lynn Sadler
• Savannah Rose Wellness
• Seaside Counseling Services, PLLC
• Shoreview Medical Associates, PLLC
• Vincent Robert Smith, DDS
• Hannah Solum, LICSW
• Karen Lee Stebbins, RN
• Timothy C Swing, DDS

All providers in Carolina Beach, NC · Internal Medicine Physician in North Carolina