| Act Medical Group Pa | |
|
311-4e Judges Rd Wilmington NC 28405-3655 | |
| (910) 791-6767 | |
| (910) 791-6890 |
| Full Name | Act Medical Group Pa |
|---|---|
| Speciality | Specialist |
| Location | 311-4e Judges Rd, Wilmington, North Carolina |
| Authorized Official Name and Position | Erinn M Beekman (PRESIDENT) |
| Authorized Official Contact | 9107916767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Act Medical Group Pa Po Box 696 Hampstead NC 28443 Ph: (910) 791-6767 | Act Medical Group Pa 311-4e Judges Rd Wilmington NC 28405-3655 Ph: (910) 791-6767 |
| NPI Number | 1245219799 |
|---|---|
| Provider Enumeration Date | 01/12/2006 |
| Last Update Date | 12/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245219799 | NPI | - | NPPES |
| 016UG | Other | NC | BCBSNC PRIMARY CARE ONLY |
| 0706G | Other | NC | BCBSNC MENTAL HEALTH ONLY |
| 890706G | Medicaid | NC | |
| 6005401 | Medicaid | NC | |
| CI3714 | Other | NC | RAILROAD MEDICARE |
| 20992 | Other | NC | PIEDMONT BEHAVIORAL HEALT |
| E698 | Other | NC | PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 174400000X | Specialist | 87550 (North Carolina) | Primary |
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