| Eduardo Sanmiguel, MD | |
|
4402 Shipyard Blvd, Wilmington, NC 28403-6161 | |
| (910) 452-1400 | |
| (910) 332-1072 |
| Full Name | Eduardo Sanmiguel |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 4402 Shipyard Blvd, Wilmington, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639176829 | NPI | - | NPPES |
| 1191T | Other | NC | BCBS |
| Q00345 | Medicaid | SC | |
| 891191T | Medicaid | NC | |
| 01-28699 | Other | NC | UNITED HEALTHCARE |
| 930077044 | Other | NC | RAILROAD MEDICARE |
| B4557 | Other | NC | MEDCOST |
| 930084657 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 9900341 (North Carolina) | Primary |
| Entity Name | Vidant Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
| Mailing Address | Practice Location Address |
|---|---|
| Eduardo Sanmiguel, MD 401 N Main St, Kenansville, NC 28349-8801 Ph: (910) 296-2774 | Eduardo Sanmiguel, MD 4402 Shipyard Blvd, Wilmington, NC 28403-6161 Ph: (910) 452-1400 |
Dr. Heston Channing Lamar, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1612 Azalea Dr, Wilmington, NC 28403 Phone: 910-538-4009 Fax: 910-335-8967 | |
Russell Anthony Incatasciato, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-452-1400 Fax: 910-791-9626 | |
Kevin John Reese, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-452-1400 Fax: 910-791-9626 | |
Michael Robert Ott, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-452-1400 Fax: 910-332-1032 | |
Lisa A Plazzo, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-452-1400 Fax: 910-791-9626 | |
Dr. Robert Lee Young, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-667-7000 | |
Dr. Sean Patrick O'brien, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-202-3363 Fax: 910-791-9626 |