| Coastal Neurology Pllc | |
|
1514 Doctors Cir Wilmington NC 28401-7404 | |
| (910) 254-9914 | |
| (910) 254-9953 |
| Full Name | Coastal Neurology Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1514 Doctors Cir, Wilmington, North Carolina |
| Authorized Official Name and Position | Sandra Susan Torres (OWNER) |
| Authorized Official Contact | 9102549914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Neurology Pllc Po Box 3518 Wilmington NC 28406-0518 Ph: (910) 254-9914 | Coastal Neurology Pllc 1514 Doctors Cir Wilmington NC 28401-7404 Ph: (910) 254-9914 |
| NPI Number | 1427227701 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 03/21/2015 |
| Medicare PECOS PAC ID | 1850470089 |
|---|---|
| Medicare Enrollment ID | O20080429000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427227701 | NPI | - | NPPES |
| 5909197 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0008X | Psychiatry & Neurology - Neuromuscular Medicine | 34183 (North Carolina) | Primary |
| Provider Name | Sandra S Torres |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518068154 PECOS PAC ID: 8123107356 Enrollment ID: I20080429000959 |
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