ATLANTIC INTERNAL MEDICINE PA NPI 1982621546

NPI Information

NPI: 1982621546
Provider Name: ATLANTIC INTERNAL MEDICINE PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 34D0245990

Address:
16 MEDICAL CENTER DR
SUPPLY, NC
ZIP 28462
Phone: (910) 754-8921
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ATLANTIC INTERNAL MEDICINE PA is a primary care clinic center in Supply, NC. ATLANTIC INTERNAL MEDICINE PA NPI is 1982621546. The provider is registered as an organization entity type.

The provider's business location address is:

16 MEDICAL CENTER DR
SUPPLY, NC
ZIP 28462-350
Phone: (910) 754-8921
Fax: (910) 754-7140

The provider's authorized official is Richard D. Crane .
The authorized official title is President and has the following contact phone number (910) 754-8921.

The CLIA number assigned to this NPI record is 34D0245990 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 2/1/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	79013FE	MEDICAID	NORTH CAROLINA
2	013FE	OTHER	NORTH CAROLINA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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