| Organization Name: | MARIA MEDICAL CENTER, PPLC |
| NPI Number: | 1104050046 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSETTE MARIA (MEDICAL DIRECTOR/PRESIDENT) |
| Mailing Address: | 800 Susan Tart Rd Dunn |
| State: | NC US |
| Postal Code: | 283345506 |
| Phone Number: | 9108928892 |
| Fax Number: | |
| NPI Enumeration Date: | 05/06/2009 |
| NPI Last Update Date: | 05/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 200100412 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |