Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jun 27, 2005
License(s)
2011-01732 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1202 MEDICAL CENTER DR | Wilmington, NC 28401-7307 | 910-341-3300 |
| LOCATION | 8090 MARKET ST | Wilmington, NC 28411-9384 | 910-341-3300 |
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